The nurse determines that instruction regarding prevention of ...

[Pineappleeh]

The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states which of the following?
 
  a. I can use vaginal antiseptic sprays to reduce bacteria.
  b. I will drink a quart of water or other fluids every day.
  c. I will wash with soap and water before sexual intercourse.
  d. I will empty my bladder every 3 to 4 hours during the day.

Question 2

A 46-year-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?
 
  a. Teach the patient to take the prescribed Bactrim for 3 more days.
  b. Remind the patient about the need to drink 1000 mL of fluids daily.
  c. Obtain a midstream urine specimen for culture and sensitivity testing.
  d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.

[jomama]

Answer to Question 1

ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is discouraged. The bladder should be emptied before and after intercourse, but cleaning with soap and water is not necessary. A quart of fluids is insufficient to provide adequate urine output to decrease risk for UTI.

Answer to Question 2

ANS: C
Because uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy. Acetaminophen would not be as effective as other over-the-counter (OTC) medications such as phenazopyridine (Pyridium) in treating dysuria. The fluid intake should be increased to at least 1800 mL/day. Because the UTI has persisted after treatment with Bactrim, the patient is likely to need a different antibiotic.