Author Question: A female client has been provided with a 3-day course of therapy as prophylaxis against another ... (Read 33 times)

karlynnae · **on:** Jul 23, 2018

A female client has been provided with a 3-day course of therapy as prophylaxis against another urinary tract infection. Which statement indicates that the client understands when to use this medication?

1. I will take this medication on the first 3 days of the month.
2. I will take this medication after my husband and I have sexual intercourse.
3. When I first have symptoms, I will drink cranberry juice. If that is not effective, I will take the medication.
4. If I develop symptoms of an infection, I will call the health care provider and make sure it is OK for me to go ahead and take the medication.

Question 2

A client is diagnosed with a urinary tract infection (UTI). The health care practitioner elects to treat the client with ciprofloxacin (Cipro).

The client asks the nurse why she isn't receiving trimethoprim-sulfamethoxazole (TMP-SMZ), the drug she was given 8 months ago for a UTI. What would be the most accurate response?
1. Many clients have developed resistance to TMP-SMZ, so that drug isn't used as much.
2. It is obvious that the TMP-SMZ didn't clear up your infection the first time, so you are being given another medication.
3. I'm sure there is a good reason why you are being given this different medication.
4. Cipro is less expensive than the drug you took the last time.

nickk12214 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: With self-initiated therapy, the medication is intended to be taken when symptoms occur, not on specific days of the month.
Rationale 2: Prophylactic therapy is intended to be used after each act of coitus, or when symptoms first develop.
Rationale 3: The medication is intended to be taken at the first sign of symptoms; the client should not delay treatment by trying something else.
Rationale 4: The health care provider has given the client the means to initiate therapy, so the client does not need to call and get permission to use the medication.
Global Rationale: With this type of treatment, the patient is provided with a single dose or 3-day course of therapy, which is initiated by the woman after each act of coitus, or when symptoms first develop. The medication is intended to be taken at the first sign of symptoms; the client should not delay treatment by trying something else.

Answer to Question 2

Correct Answer: 1
Rationale 1: Many strains are resistant to TMP-SMZ, so its use as a first-line agent has been limited. Cipro is equally effective and has not developed as much resistance.
Rationale 2: The client had the other infection 8 months ago, so this response is not correct.
Rationale 3: The client has asked for an explanation. The nurse did not answer the client's question.
Rationale 4: Medications might be prescribed according to cost, but in this case, Cipro is newer and more expensive than TMP-SMZ, which has been used for a long time.
Global Rationale: The nurse should be prepared to answer the client's questions. Many strains of bacteria are resistant to TMP-SMZ, so its use as a first-line agent has been limited. Cipro is equally effective and has not developed as much resistance. Since the previous infection was 8 months ago, this is not a reinfection. Cipro is typically more expensive than TMP-SMZ.