A woman is in the 36th week of pregnancy. The nurse practitioner ...

[JGIBBSON]

A woman is in the 36th week of pregnancy. The nurse practitioner (NP) providing prenatal care learns that the woman has a history of two previous urinary tract infections during this pregnancy.
 
  A dipstick urinalysis in the office today is negative for leukocyte esterase and nitrites. The NP should: a. prescribe a low-dose sulfonamide antibiotic for urinary tract infection prophylaxis.
  b. order nitrofurantoin daily to minimize the patient's risk of urinary tract infection late in her pregnancy.
  c. encourage the patient to increase daily water intake and to wear only cotton underwear.
  d. order a voiding cystourethrogram to rule out structural anomalies that may cause urinary tract infection.

Question 2

An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature.
 
  The NP should: a. discontinue the medication.
  b. order serum drug levels to evaluate toxicity.
  c. report the prescribing provider to the Food and Drug Administration (FDA).
  d. ask the parent about the drug's use and side effects.

[allisonblackmore]

Answer to Question 1

C
For women at risk for recurrent urinary tract infection while pregnant, prevention and treatment begin with nonpharmacologic therapy: forcing fluids and wearing cotton underpants. Sulfonamide antibiotics and nitrofurantoin are used for documented urinary tract infection during pregnancy, but not after the 36th week of gestation. A voiding cystourethrogram is not indicated and would expose the fetus to radiation.

Answer to Question 2

D
Many of the drugs and biologic products most widely used in pediatric patients carry disclaimers stating that safety and effectiveness in pediatric patients have not been established. The NP should find out why the drug was prescribed and whether there are any significant side effects. The medication should not be discontinued unless there are known toxic effects. Serum drug levels may be warranted if side effects are reported. The NP would not report the prescribing provider to the FDA unless there are clear, evidence-based contraindications to prescribing a drug to children.

[JGIBBSON]

Both answers were spot on, thank you once again

[allisonblackmore]

Great! Please up vote