Page 1901 - Saunders Comprehensive Review For NCLEX-RN

12. Inform the client that some combination medications
of sulfonamides can cause the urine to turn dark
brown or red.
13. The sulfonamide combination of trimethoprim-
sulfamethoxazole is more effective than either
medication alone, because it inhibits the sequential
steps in bacterial folic acid synthesis.
14. Trimethoprim-sulfamethoxazole is used cautiously
with clients experiencing impaired kidney function,
folate deficiency, severe allergy, or bronchial asthma.
15. An intravenous (IV) dose of trimethoprim-
sulfamethoxazole is administered over 60 to 90
minutes and is not mixed with other medications.

Sulfonamides should be withheld if a rash is noted. Inform the

client to contact the PHCP if a rash appears.
IV. Urinary Tract Analgesics (Box 55-4)

A. Description: A urinary tract analgesic is administered with

an antibiotic because the analgesic only treats pain, not the
infection.
B. Side and adverse effects
1. Nausea
2. Headache
3. Vertigo
C. Nursing considerations
1. Instruct the client that the urine will turn red

or orange and could stain clothing; tears and contact
lenses will also become red or orange tinged.
2. A urinary tract analgesic is contraindicated in clients
with renal or hepatic disease.
3. The medication interferes with accurate urine testing
for glucose and ketones.
V. Anticholinergics/Antispasmodics (Box 55-5)
A. Description: Used for overactive bladder (urge incontinence)
B. Side and adverse effects

1. Anorexia, nausea, vomiting, and dry mouth

2. Blurred vision
3. Confusion in older clients
4. Constipation
5. Decreased sweating
6. Dizziness
7. Drowsiness

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