Question

UTI-trimethoprim-sulfamethoxazole RM, a 46-year-old woman, has a severe urinary tract infection. She takes trimethoprim sulfamethoxazole (Bactrim) 160mg 800mg every 6 hours. 1. Is the dose within the recommended drug dose and dosing interval? What is the nurse's responsibility? 2. What are the similarities and differences between trimetboprim-sulfamethoxazole and 3. What are the signs of thrombocytopenia, bemolytic anemia, and agranulocytosis for sulfadiazine? patients who take high doses of sultonamides? 4. Explain the assessment and aursing interventions regarding these severe adverse reactions to sul fonamides 5. Patient teaching is an important part of nursing interventions. Explain the nurse's role regarding patient teaching concerning the following: A What is the required amount of daily fluid intake? B What are the cross-sensitive effects if a patient is allergic to other sulfonamides preparations? What allergic reactions may oocur? C What time of the day sbould sulfonamides be taken? D Why should bruising and bleeding be reported? E What protective measures should be taken to prevent a possible photosensitivity? RM takes the anticoagulant Coumadin 7,5mg daily 6. What effect does Bactrim have on warfarin (Coumadin)? 8. Sbould RM's coumadin dosage be increased or decreased? Explain you answer Reviewed 12/18

Answer 1

1. the recommended dose for Adult with UTI is Bactrim DS (Trimethoprim/ sulfamethoxazole- 160/800mg) is every 12 hours for 10-14 days. Nurses responsibility is monitor for skin rashes, intake/ output chart, other side effect.

2. Trimethoprim -sulfamethoxazole and trimethoprim and sulfadiazidine both are having same synergestic effect against UTI, usually for resistance case of sulfamethoxazole combinations sulfadiazine combinations.

sulfadiazine can combined with pyrimethamine to treat toxoplasmosis.

3. Thrombocytopenia- easy bruising and increased bleeding tendency

Hemolytic anemia - yellowish discolouration of skin and mucous membrane, dark urine, increased heart rate

Agranulocytosis- fever, sore throat, chills

4. Nurses should assess for hives, wheezing, bruising, yellowish discoloration of skin, cbc count.

monitor for temperature,heart rate, blood pressure, spo2. Manage low spo2 with position and o2 adminstration like vice versa, even it is not much effective as the problem is with the rbc count.

Report to the physician immediately.

send sample for blood grouping and typing, arrange for whole blood transfusion.

5. A. Drink much more fluids- 2.5 - 2litres/ day. Take tablet with full one glass of water.

B. hives, wheezing, itchy skin and eyes

c. sulfanomides are photosensitive drug, so as much as possible it should not take during sunny time,but interval time between each dose should be same.

d. bruising and bleeding are signs of thrombocytopenia. It needs immediate attention as it may risk to cause death due to blood loss.

E. Protective clothing, sun creams, using hat , cover whole body as protective from sun. As much as possible avoid exposure to sun.