A patient with a urinary tract infection is given a prescription ...

[RYAN BANYAN]

A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do?
 
  a. Contact the provider to request a different antibiotic for this patient.
  b. Obtain frequent blood glucose determina-tions while giving TMP/SMZ.
  c. Suggest that the patient take a potassium supplement while taking TMP/SMZ.
  d. Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.

Question 2

A nurse is providing education to a patient preparing for discharge from the clinic. The nurse understands that the best way to promote compliance in the patient going home on a new medi-cation is to
 
  a. provide a video for the patient to watch at home.
  b. provide a pamphlet on the new medication.
  c. monitor the patient for an adverse drug response prior to discharge.
  d. ask the patient to restate the instructions and verify understanding.

[softEldritch]

Answer to Question 1

A
Alcoholics are likely to be folate deficient and have an increased risk of megaloblastic anemia when taking TMP/SMZ, so withholding this drug in this population is recommended. TMP/SMZ shares hypersensitivity reactions with oral sulfonylurea-type hypoglycemics that are used with type 2 diabetes mellitus, so it is not necessary to assess the blood glucose level more often. TMP/SMZ can cause hyperkalemia, so potassium supplements are contraindicated. Patients tak-ing TMP/SMZ should consume more fluids to maintain renal blood flow and prevent renal dam-age.

Answer to Question 2

D
Having the patient to restate the instructions allows the nurse to verify patient understanding.
The nurse will not be able to assess whether the patient learned from the video, because the pa-tient will watch it at home after discharge.
The nurse will not be able to assess whether the patient actually read the pamphlet and unders-tood its contents.
Monitoring the patient does not ensure compliance with the medication and is not indicated in this situation.

DIF: Cognitive Level: Application REF: p. 7
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

[RYAN BANYAN]

Thanks for the timely response, appreciate it

[scottmt]

TYSM