For which client is the use of nitrofurantoin (Furadantin) contraindicated?
1. The client who needs a rescue inhaler for asthma three times a week
2. The client who has pernicious anemia
3. The client who developed nausea the last time she took the drug
4. The client who had hepatitis A 10 years ago
Correct Answer: 1
Rationale 1: Nitrofurantoins are contraindicated in clients with preexisting pulmonary disorders such as poorly controlled asthma.
Rationale 2: Clients with pernicious anemia are not affected by nitrofurantoin. Sulfonamides are contraindicated in clients with pernicious anemia.
Rationale 3: Nausea is a common side effect in clients who take nitrofurantoin, and would not contraindicate the use of this medication again.
Rationale 4: Nitrofurantoins are contraindicated in clients with liver dysfunction. A client who had hepatitis A 10 years also could have liver dysfunction, but most clients recover without liver dysfunction.
Global Rationale: This drug should be used with caution in patients with preexisting pulmonary disease, and pulmonary function should be closely monitored throughout therapy. Although rare, reports have cited diffuse interstitial pneumonitis or pulmonary fibrosis as causes of death in patients receiving nitrofurantoin. Clients with pernicious anemia are not affected by nitrofurantoin. Sulfonamides are contraindicated in clients with pernicious anemia. Nausea is a common side effect in clients who take nitrofurantoin, and would not contraindicate the use of this medication again. Nitrofurantoins are contraindicated in clients with liver dysfunction. A client who had hepatitis A 10 years also could have liver dysfunction, but most clients recover without liver dysfunction.
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