A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do?
a. Contact the provider to request a different antibiotic for this patient.
b. Obtain frequent blood glucose determina-tions while giving TMP/SMZ.
c. Suggest that the patient take a potassium supplement while taking TMP/SMZ.
d. Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.
A
Alcoholics are likely to be folate deficient and have an increased risk of megaloblastic anemia when taking TMP/SMZ, so withholding this drug in this population is recommended. TMP/SMZ shares hypersensitivity reactions with oral sulfonylurea-type hypoglycemics that are used with type 2 diabetes mellitus, so it is not necessary to assess the blood glucose level more often. TMP/SMZ can cause hyperkalemia, so potassium supplements are contraindicated. Patients tak-ing TMP/SMZ should consume more fluids to maintain renal blood flow and prevent renal dam-age.
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