Reproductive System Disorders Q 16 - Gyan Darpan : Learning Portal
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Sunday, 3 April 2022

Reproductive System Disorders Q 16

A female client with a urinary tract infection is prescribed co-trimoxazole (trimethoprim-sulfamethoxazole). Nurse Dolly should provide which medication instruction?
    A. “Take the medication with food.”
    B. “Drink at least eight 8-oz glasses of fluid daily.”
    C. “Avoid taking antacids during co-trimoxazole therapy.”
    D. “Don’t be afraid to go out in the sun.”

Correct Answer: B. “Drink at least eight 8-oz glasses of fluid daily.”

When receiving a sulfonamide such as co-trimoxazole, the client should drink at least eight 8-oz glasses of fluid daily to maintain a urine output of at least 1,500 ml/day. Otherwise, inadequate urine output may lead to crystalluria or tubular deposits. Sulfamethoxazole/trimethoprim may be administered orally without regard to meals. However, it is best to take it with at least 8 ounces of water.

Option A: For maximum absorption, the client should take this drug at least 1 hour before or 2 hours after meals. Administration of the two drugs is in a 1 to 5 ratio (trimethoprim: sulfamethoxazole) as a tablet formulation; this is so when they enter the body, their concentration throughout the blood/tissues is 1 to 20, which is the peak synergistic desired effect ratio of the two drugs in combination.
Option C: No evidence indicates that antacids interfere with the effects of sulfonamides. When initiating therapy with trimethoprim/sulfamethoxazole, some patients may require a baseline blood urea nitrogen and serum creatinine ratio, frequent complete blood counts (CBC), and electrolyte measurements if renal impairment is known or if taking a drug that has interactions with potassium.
Option D: To prevent a photosensitivity reaction, the client should avoid direct sunlight during co-trimoxazole therapy. The primary adverse effects of trimethoprim/sulfamethoxazole include rash, photosensitivity, as well as folate deficiency.

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