Page 1898 - Saunders Comprehensive Review For NCLEX-RN

generates ammonia; therefore, it
should not be used for clients with
liver dysfunction.

f. Methenamine requires acidic

urine with a pH of 5.5 or lower.

g. Increasing fluid intake reduces

antibacterial effects by diluting the
medication and raising urine pH.

h. Methenamine should not be

combined with sulfonamides because
of the risk of crystalluria and urinary
tract injury.

i. Clients taking this medication

should avoid alkalinizing agents,
including over-the-counter antacids
containing sodium bicarbonate or
sodium carbonate.
3. Nitrofurantoin
a. Gastrointestinal effects include
anorexia, nausea, vomiting, and
diarrhea; administration with milk or
meals minimizes gastrointestinal
distress.

b. Pulmonary reactions include

dyspnea, chest pain, chills, fever,
cough, and alveolar infiltrates; these
resolve in 2 to 4 days following
cessation of treatment.
c. Hematological effects include
agranulocytosis, leukopenia,
thrombocytopenia, and megaloblastic
anemia.
d. Peripheral neuropathy effects include
muscle weakness, tingling sensations,
and numbness.
e. Neurological effects include headache,
vertigo, drowsiness, and nystagmus.
f. Allergic reactions include anaphylaxis,
hives, rash, and tingling sensations
around the mouth.

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