The nurse is caring for a client taking sulfonamides to treat a urinary tract infection. Which of the following should the nurse monitor for in this client? Select all that apply.

  • fever or sore throat
  • reddish-pink urine
  • side effects such as dyspnea, chest pains, chills, and cough
  • urinary output of 1200 mL daily to minimize the risk of renal damage
  • the need to decrease the dosage if the client takes warfarin sodium (Coumadin) or phenytoin (Dilantin)
Numbers 1, 4, and 5 are correct.
The nurse should monitor for fever or sore throat, as sulfonamides can cause leukopenia, hemolytic anemia, thrombocytopenia, and agranulocytosis. If the client develops a fever or sore throat, the health care provider should be notified. The client should drink 8 – 10 glasses of water daily to maintain daily urinary output of 1200 mL to minimize the risk of renal damage. If the client takes warfarin sodium, phenytoin, or oral hypoglycemics, it may be necessary to reduce the dosage of the medication: sulfonamides potentiate the effects of those drugs. Sulfonamides can cause the urine to turn dark brown or red when taken with some combination sulfonamide medications. Dyspnea, chest pains, chills, and cough are side effects of urinary tract antiseptics such as Macrodantin and Macrobid.