Clients taking Pyridium should be taught that the medication will turn the urine orange or red. Pyridium can also cause a yellowish color to skin and sclera if taken in large doses. Phenazopyridine relieves urinary tract pain, burning, irritation, and discomfort, as well as urgent and frequent urination caused by urinary tract infections, surgery, injury, or examination procedures. However, phenazopyridine is not an antibiotic; it does not cure infections.

Option A: It does not cause diarrhea. Phenazopyridine comes as a tablet or capsule to take by mouth. It usually is taken three times a day after meals. Do not chew or crush the tablets as it may cause your teeth to become stained; swallow them whole with a full glass of water. You may stop taking this drug when pain and discomfort completely disappear.
Option C: The drug does not cause mental confusion. Phenazopyridine can interfere with laboratory tests, including urine tests for glucose (sugar) and ketones. If you have diabetes, you should use Clinitest rather than Tes-Tape or Clinistix to test your urine for sugar. Urine tests for ketones (Acetest and Ketostix) may give false results. Before you have any tests, tell the laboratory personnel and doctor that you take this medication.
Option D: It is not associated with changes in taste. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Accutane is contraindicated for use by pregnant clients because it causes teratogenic effects. Isotretinoin was a pregnancy category X drug under the previous FDA system and is contraindicated in women who are pregnant or who may become pregnant. There have been severe, documented congenital disabilities when pregnant women have taken isotretinoin.

Option A: Calcium levels are unnecessary. To prescribe and receive isotretinoin, the Food and Drug Administration requires prescribers and patients to register with the iPLEDGE program. iPLEDGE ensures the fulfillment of appropriate requirements before the distribution of isotretinoin to prevent the use of this medication during pregnancy.
Option C: Apical pulse is not necessary. Two negative pregnancy tests are necessary before the initiation of therapy with isotretinoin. The first pregnancy test occurs up to 30 days prior to medication initiation. The second pregnancy test must occur at least 19 days after the first negative pregnancy test and within the first five days of the patient’s menstrual cycle. Each subsequent month the patient must have a recorded negative pregnancy test to continue therapy. After discontinuation of therapy, a final pregnancy test should take place at 30 days following therapy completion.
Option D: Liver function tests (LFTs), fasting lipid profile (including triglycerides), blood glucose, creatinine phosphokinase (CPK), and complete blood counts (CBC) with differential should be drawn before initiating therapy with isotretinoin. Screening for mood alteration, psychosis, aggression, suicidal ideation, skin changes, and visual changes should also take place prior to starting therapy.

Clients taking Acyclovir should be encouraged to drink plenty of fluids because renal impairment can occur. Acute kidney injury (AKI) is the most significant side effect of parenteral acyclovir administration. The incidence of AKI is comparable to other nephrotoxic medications such as aminoglycosides. Patients with CKD are at higher risk. Dose adjustment of acyclovir for ideal body weight and baseline renal function is imperative.

Option A: Limiting activity is not necessary. Patients should be monitored for adverse effects such as malaise, inflammation or phlebitis at infusion site, nausea, vomiting, rash (including Steven-Johnson syndrome), transaminitis, nausea, vomiting, diarrhea, headache, abdominal pain, aggression/confusion, agitation, alopecia, anaphylaxis, anemia, angioedema, anorexia, ataxia, coma, disseminated intravascular coagulation (DIC), dizziness and fatigue.
Option B: Eating a high-carbohydrate diet is unnecessary. When taken orally, acyclovir may be taken with or without food 2 to 5 times a day for 5 to 10 days as well as up to 12 months to prevent outbreaks of genital herpes. For limited mucocutaneous lesions, acyclovir administration can be via the oral route. In cases in which there is disseminated, visceral, or CNS involvement, the acyclovir administration should be intravenous.
Option C: Use of an incentive spirometer is not specific to clients taking Acyclovir. A study regarding the pharmacokinetics of acyclovir demonstrated that a patient’s glomerular filtration and tubular secretion contribute to its renal excretion. Appropriate cautions are necessary when administering intravenous acyclovir to such higher-risk patients.

Although there is no evidence to suggest MRI scans can pose a risk during pregnancy, it is considered precaution to not perform MRI during pregnancy, particularly in the first three months. This is particularly the case during the first trimester of pregnancy, as organogenesis takes place during this period. The concerns in pregnancy are the same as for MRI in general, but the fetus may be more sensitive to the effects—particularly to heating and to noise.

Option B: Clients with a titanium hip replacement can have an MRI. Some other devices and implants might be contraindicated. To ensure patients’ safety, the radiologist and MRI technologist must evaluate the type of device that patients have. Radiologists, referring physicians and MR technologists, need to be able to assess MRI safety, patients’ condition, and compatibility of medical devices to keep patients safe.
Option C: No antibiotics are used with this test. MRI contrast agents are gadolinium chelates with different stability, viscosity, and osmolality. Gadolinium is a relatively very safe contrast; however, it rarely might cause allergic reactions in patients.
Option D: The client should remain still only when instructed. Patients who are unable to be still or obey breathing instructions in the scanner need special attention. Some patients in pain might move during the procedure, which degrades the quality of the images, restrict the interpretation, and decrease the accuracy of the report. Some MRI sequences need to be obtained while patients hold their breath and lie motionless.

Clients taking Amphotericin B should be monitored for liver, renal, and bone marrow function because this drug is toxic to the kidneys and liver, and causes bone marrow suppression. Jaundice is a sign of liver toxicity and is not specific to the use of Amphotericin B. Due to the similarity of mammalian and fungal membranes, which both contain sterols (the therapeutic target for amphotericin B), amphotericin B can exhibit cellular toxicity.

Option A: Changes in vision are not related. Other potential uncommon side effects include demyelinating encephalopathy in patients with bone marrow transplant with total body irradiation or who are receiving cyclosporine.
Option B: Nausea is a side effect, not a sign of toxicity. Monitoring is a recommendation to evaluate for the presence of side effects. Initially, a daily electrolyte panel, including potassium and magnesium concentrations until the dose increases to its therapeutic level, and after that, weekly electrolyte concentrations are sufficient. Clinicians should obtain potassium concentrations immediately if the patient presents with any signs of hypokalemia, such as muscle weakness, cramps, drowsiness, or ECG changes of hypokalemia.
Option C: Urinary frequency is a side effect. Renal toxicity correlates with conventional amphotericin B use and can lead to renal failure and requirement for dialysis. But the azotemia often stabilizes with therapy and renal damage is reversible after discontinuation of amphotericin B.