UNIT NINE
698
Understanding the Urinary System
Table 37.2 Medications Used to Treat Urinary Tract Infections
Medication Class/Action Antibiotics Effective against E. coli and Enterococcus faecalis Example fosfomycin (Monurol)
Nursing Implications Dissolve packet in ½ cup of cool water to drink immediately. Teach: Only 1 dose is needed for UTI. Diarrhea is a common side effect that subsides when medication is stopped.
Effective against E. coli, enterococci, Staphylococcus aureus, Klebsiella spp., and Enterobacter Example nitrofurantoin (Macrobid, Macrodantin) Nursing Implications Teach: Avoid taking with antacids. Take with food or milk and full glass of water. Beta-Lactam Antibiotics Effective against Escherichia coli, Klebsiella spp., and Serratia Example
Nursing Implications Check allergies and renal function.
ceftriaxone (Rocephin) cefepime (Maxipime) aztreonam (Azactam)
Fluoroquinolones Effective against E. coli, Klebsiella spp., Pseudomonas, and other organisms. Example ciprofloxacin (Cipro) levofloxacin (Levaquin)
Nursing Implications Do not give if pregnant. Absorption may be decreased if given within 2 hr of aluminum antacids. Give with large amounts of water. Teach:
Avoid sunlight or wear sunscreen of 30 HPF or more. Report tendon aches promptly as tendon may rupture.
Sulfonamides Effective against E. coli; used for uncomplicated UTIs. Example trimethoprim-sulfamethoxazole (Bactrim, Septra)
Nursing Implications Do not give if allergic to sulfa. Do not give if pregnant. Dose may need adjustment with renal disease. Teach: Avoid sunlight or wear sunscreen of 30 SPF or more. Take with large amounts of water.
Urinary Analgesic Topical analgesic that relieves pain urgency and frequency associated with UTI. Example phenazopyridine (Pyridium) Nursing Implications Urine color changes to red-orange.
Avoid in renal insufficiency. Changes urine glucose testing.
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