NCLEX Prep II Renal and Urinary Medications Chapter 59 (Answered) With Rationale

NCLEX Prep II Renal and Urinary Medications Chapter 59 (Answered) With Rationale Parenteral bethanechol chloride is prescribed for a client with urinary retention. The nurse should plan to administer this medication by which route? 1.Intravenously 2.Intradermally 3.Intramuscularly 4.Subcutaneously 4.Subcutaneously Rationale: The injectable form of bethanechol chloride is intended for subcutaneous administration only. Bethanechol must never be injected intramuscularly or intravenously because the resulting high medication level can cause severe toxicity, resulting in bloody diarrhea, bradycardia, profound hypotension, and cardiovascular collapse. A client taking metronidazole telephones the home health nurse to report dark discoloration to the urine. The nurse interprets that the client's complaint warrants which nursing action at this time? 1.Instruct the client to increase fluid intake. 2.Tell the client to discontinue the medication. 3.Instruct the client to call the health care provider (HCP). 4.Tell the client that this is a harmless medication side effect. 4.Tell the client that this is a harmless medication side effect. Rationale: Harmless darkening of the urine may occur, and the client should be told of this effect. Metronidazole can produce a variety of side effects, but they rarely require termination of treatment. Increasing fluid intake is a good health measure but will not prevent this side effect from occurring. It is not necessary to discontinue the medication or call the HCP. A client is receiving oxybutynin. The nurse should suspect that this medication is prescribed to relieve which condition? 1.Gastritis 2.Renal calculi 3.Ulcerative colitis 4.Overactive bladder 4.Overactive bladder Rationale: When medication therapy for overactive bladder is indicated, anticholinergic agents are the medications generally prescribed. These medications block muscarinic receptors on the bladder detrusor and thereby inhibit bladder contractions and decrease the urge to void. It is not used to treat gastritis. The medication would not be used to treat renal calculi or ulcerative colitis. In fact, it may make those conditions worse. The nurse is taking care of a client receiving oxybutynin. Which finding should the nurse expect to note if the client develops side or adverse effects of this medication? 1.Itching 2.Diarrhea 3.Swelling 4.Dry mouth 4.Dry mouth Rationale: Oxybutynin is an anticholinergic. Anticholinergic side effects include dry mouth, constipation, tachycardia, urinary hesitancy, urinary retention, mydriasis, blurred vision, and dry eyes. Itching, diarrhea, and swelling are not associated with this medication. The nurse, who is administering bethanechol chloride, is monitoring for cholinergic overdose associated with the medication. The nurse should check the client for which sign of overdose? 1.Dry skin 2.Dry mouth 3.Bradycardia 4.Signs of dehydration 3.Bradycardia Rationale: Cholinergic overdose of bethanechol chloride produces manifestations of excessive muscarinic stimulation such as salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. Remember that the sympathetic nervous system speeds the heart rate and the cholinergic (parasympathetic) nervous system slows the heart rate. Treatment includes supportive measures and the administration of atropine sulfate (anticholinergic) subcutaneously or intravenously. Tamsulosin hydrochloride is prescribed for a client. The nurse should suspect that this medication is prescribed to relieve which condition? 1.Constipation 2.Muscle spasms 3.Urinary obstruction 4.Respiratory congestion 3.Urinary obstruction Rationale: Tamsulosin hydrochloride is used to relieve mild to moderate manifestations that occur in benign prostatic hypertrophy. The medication also improves urinary flow rates. This medication is not used to treat constipation, muscle spasms, or respiratory congestion. The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list? 1.Advise that sunscreen is not needed. 2.Drink 8 to 10 glasses of water per day. 3.If the urine turns dark brown, call the health care provider (HCP) immediately. 4.Decrease the dosage when symptoms are improving to prevent an allergic response. 2.Drink 8 to 10 glasses of water per day. Rationale: Each dose of trimethoprim-sulfamethoxazole should be administered with a full glass of water, and the client should maintain a high fluid intake to avoid crystalluria. The medication is more soluble in alkaline urine. The client should not be instructed to taper