Pharm UTI/Diuretics

Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. Which would the nurse reinforce to the client?

• Take the medication at bedtime.

• Take the medication before meals.

• Discontinue the medication if a headache occurs.

• A reddish-orange discoloration of the urine may occur.

Answer explanation

The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should instruct the client that this discoloration can stain fabric. The medication should be taken after meals to reduce the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication.

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which would the nurse recognize as potential adverse effects? Select all that apply.

• Nausea

• Tinnitus

• Increased urinary frequency

• Hypotension

• Hypokalemia

A client receiving nitrofurantoin calls the primary health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

• Nausea

• Diarrhea

• Anorexia

• Chest pain

The nurse is preparing to administer furosemide to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to review before administering this medication?

• Potassium level

• Creatinine level

• Cholesterol level

• Blood urea nitrogen (BUN)

Answer explanation

Furosemide is a loop diuretic. The medication causes a decrease in the client's electrolytes, especially potassium, sodium, and chloride. Administering furosemide to a client with a low potassium level could precipitate ventricular dysrhythmias. The options of BUN and creatinine reflect renal function. The cholesterol level is unrelated to the administration of this medication.

A potassium-retaining diuretic is prescribed for a client with heart failure. Which foods would the nurse instruct the client to avoid?

• Plums

• Bananas

• Cranberry juice

• Cheddar cheese

The nurse is monitoring a client receiving spironolactone by mouth daily. Which data would indicate to the nurse that the client is experiencing a side effect related to the medication?

• Client complaints of dry skin

• A sodium level of 140 mEq/L

• A potassium level of 5.2 mEq/L

• Client complaints of constipation

Answer explanation

Spironolactone is a potassium-retaining diuretic. Side effects include hyperkalemia, dehydration, hyponatremia, and lethargy. Although the concern with most diuretics is hypokalemia, this medication is potassium-retaining, which means that the concern with the administration of this medication is hyperkalemia. The normal sodium level is 135 to 145 mEq/L, and the normal potassium level is 3.5 to 5.0 mEq/L. Additional side effects include nausea, vomiting, cramping, diarrhea, headache, ataxia, drowsiness, confusion, and fever. Dry skin is unrelated to the administration of this medication.

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" Which action can the nurse suggest to assist the client in successfully adapting to this therapy?

• Limiting oral fluids before bedtime

• Taking a sleep aid with the medication

• Switching to a morning administration of the medication

• Asking the primary health care provider for a new brand of medication

A client with aldosteronism has been instructed on spironolactone treatment. Which client statement indicates that the client needs further teaching about the medication?

• "My potassium level will increase."

• "This medication will make me void frequently."

• "My blood pressure should get back to normal."

• "This medication will decrease my blood glucose."

Answer explanation

Spironolactone is a potassium-retaining diuretic. It does not lower blood glucose. Spironolactone counteracts the effect of aldosterone, promotes sodium and water excretion, decreases circulating volume, and therefore decreases blood pressure and inhibits the excretion of potassium.

The client has been prescribed nitrofurantoin sodium. The nurse would determine the therapy is effective if which result is noted?

• Cessation of cough

• Absence of dysuria

• Relief of chest pain

• Decreased urge for cigarettes

Answer explanation

Nitrofurantoin sodium is an antibacterial agent and is used to treat acute urinary tract infection or as chronic suppressive treatment of urinary tract infection. It is not effective with systemic bacterial infections. Because dysuria is a sign of a urinary tract infection, this is the only correct option.

The nurse is collecting data from a client with hypertension being treated with diuretic therapy. The nurse would monitor the client for hypokalemia if the client is receiving which diuretic?

• Bumetadine

• Triamterene

• Amiloride HCl

• Spironolactone

Answer explanation

Bumetanide is a loop diuretic, which places this client at risk for hypokalemia. The nurse assesses this client carefully for signs of hypokalemia, monitors serum potassium levels, and encourages intake of potassium sources in the diet. Spironolactone, triamterene, and amiloride HCl are potassium-retaining diuretics.