The health care practitioner is preparing to prescribe trimethoprim-sulfamethoxazole (Bactrim). For which client should the nurse question an order for this medication?
1. The client who has a Shigella infection of the bowel
2. The client with P. jiroveci pneumonia
3. The client with iron-deficiency anemia
4. The client with pernicious anemia
Correct Answer: 4
Rationale 1: Trimethoprim-sulfamethoxazole is indicated for the treatment of Shigella infection of the small bowel.
Rationale 2: Trimethoprim-sulfamethoxazole is indicated for the treatment of P. jiroveci pneumonia.
Rationale 3: Trimethoprim-sulfamethoxazole should not be prescribed for clients with folate deficiency anemia. There is no reason to question the order if the client has iron deficiency anemia.
Rationale 4: Trimethoprim-sulfamethoxazole is contraindicated for clients with a folate-deficiency anemia because this drug is a folic acid inhibitor and would worsen the condition.
Global Rationale: Trimethoprim-sulfamethoxazole is contraindicated for clients with a folate-deficiency anemia because this drug is a folic acid inhibitor and would worsen the condition. There is no reason to question the order if the client has iron deficiency anemia. Trimethoprim-sulfamethoxazole is indicated for the treatment of Shigella infection of the small bowel and for treatment of P. jiroveci pneumonia.
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