A client prescribed nitrofurantoin reports coughing, chills, fever, and difficulty breathing. What should the nurse conclude?

The symptoms of coughing, chills, fever, and difficulty breathing raise concern for a pulmonary reaction to nitrofurantoin, a medication commonly used to treat urinary tract infections. Nitrofurantoin is known to potentially cause acute pulmonary reactions, particularly in predisposed individuals. These reactions can manifest as pulmonary inflammation and acute respiratory distress, which aligns with the symptoms described.

When a patient demonstrates respiratory symptoms alongside systemic signs like chills and fever, it is crucial to consider the potential for drug-related lung toxicity. In this situation, the most appropriate action would be to discontinue the medication and address the emergent respiratory issues, as continuation of nitrofurantoin could worsen the patient’s condition.

Other options may suggest different diagnoses, but they do not align with the classic presentation of a pulmonary reaction to nitrofurantoin. For instance, an allergic reaction may cause similar symptoms, but the acute respiratory symptoms specifically indicate the need for immediate cessation of the medication. Anxiety attacks or common colds typically do not present with the combination of chills, fever, and significant difficulty breathing. Thus, the conclusion points clearly to a pulmonary reaction requiring urgent attention and cessation of the drug.