Page 1900 - Saunders Comprehensive Review For NCLEX-RN

8. Inform the client of signs of hepatic and renal

toxicity and the importance of reporting these signs to
the PHCP.

Administer oral fluoroquinolones with a full glass of water and

ensure that the client maintains a urine output of at least 1200 to
1500 mL daily to minimize the development of crystalluria.
III. Sulfonamides (Box 55-3)
A. Description: Suppress bacterial growth by inhibiting the synthesis
of folic acid; active against a broad spectrum of microbes; used
primarily to treat acute UTIs
B. Side and adverse effects and nursing considerations
1. Hypersensitivity reactions include rash, fever, and
photosensitivity.
2. Stevens-Johnson syndrome, the most severe
hypersensitivity response, produces symptoms that
include widespread lesions of the skin and mucous
membranes, fever, malaise, and toxemia.
3. Sulfonamides can cause hemolytic anemia,
agranulocytosis, leukopenia, and thrombocytopenia;
instruct the client to notify the PHCP if sore throat or
fever occurs.
4. Administer sulfonamides with caution in clients with
renal impairment.
5. Sulfonamides are contraindicated if hypersensitivity
exists to sulfonamides, sulfonylureas, or thiazide or
loop diuretics.
6. Sulfonamides are contraindicated in infants younger
than 2 months and in pregnant women or mothers
who are breast-feeding.
7. Sulfonamides can potentiate the effects of warfarin
sodium, phenytoin, and orally administered
hypoglycemics (when combined with sulfonamides,
hypoglycemics may require a reduction in dosage).
8. Instruct the client to take the medication on an empty
stomach with a full glass of water.
9. Instruct the client to complete the entire course of the
prescribed medication.
10. Instruct the client to avoid prolonged exposure to
sunlight, wear protective clothing, and apply a
sunscreen to exposed skin.
11. Adults should maintain a daily urine output of at least
1200 mL by consuming 8 to 10 glasses of water each
day to minimize the risk of renal damage from the
medication.

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