A nurse is caring for a client who is receiving warfarin therapy.
Which of the following medications should the nurse expect to administer if the client develops bleeding as an adverse effect of the medication? (Select all that apply.).

Choice A rationale:

Bacteriostatic. Sulfonamides are a class of antibiotics that work primarily as bacteriostatic agents. They inhibit the growth and reproduction of bacteria by blocking the synthesis of folic acid, which is essential for bacterial DNA and RNA synthesis. By slowing down bacterial growth, sulfonamides give the body's immune system a chance to eliminate the bacteria. Bacteriostatic antibiotics do not directly kill bacteria but rather impede their ability to multiply. This action is a key characteristic of sulfonamides.

Choice B rationale:

Bactericidal. Sulfonamides are not primarily bactericidal. Bactericidal antibiotics directly kill bacteria by disrupting their cell walls, protein synthesis, or other essential processes. Sulfonamides do not have this direct killing effect. They work by inhibiting folic acid synthesis and, as a result, slowing down bacterial growth. While this can eventually lead to bacterial death, the primary action of sulfonamides is bacteriostatic.

Choice C rationale:

Promotor of folic acid activity. This choice is not accurate. Sulfonamides do not promote folic acid activity; rather, they inhibit it. Sulfonamides are structural analogs of para-aminobenzoic acid (PABA), a precursor necessary for folic acid synthesis in bacteria. By competing with PABA, sulfonamides disrupt folic acid production in bacteria, ultimately leading to growth inhibition. Therefore, they are not promoters of folic acid activity.

Choice D rationale:

Bacterial cell metabolizer. Sulfonamides do not metabolize bacterial cells. Instead, they interfere with bacterial metabolism by blocking the synthesis of folic acid. This disruption affects the DNA and RNA synthesis of bacteria, which rely on folic acid derivatives. The primary action of sulfonamides is to inhibit this metabolic pathway, not to metabolize bacterial cells.

Choice A rationale:

Instructing the patient to increase dietary intake is not the most likely intervention when a patient shows improvement with penicillin therapy. Dietary advice would be more relevant if the patient was experiencing gastrointestinal side effects or had specific nutritional needs due to their condition or treatment.

Choice B rationale:

Informing the primary health provider immediately is not typically necessary when a patient shows improvement with penicillin therapy. It's crucial to continue monitoring the patient's progress, but this choice suggests an unnecessary action.

Choice C rationale:

This is the correct answer. When a patient undergoing penicillin therapy shows improvement, the nurse should record assessments and observations on the patient's chart. This helps track the patient's progress and ensures that the healthcare team has up-to-date information about the patient's condition.

Choice D rationale: