Author Question: Which patient with a urinary tract infection will require hospitalization and intravenous ... (Read 56 times)

penguins · **on:** Jul 23, 2018

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics?

a. A 5-year-old child with a fever of 100.5 F, dysuria, and bacteriuria
b. A pregnant woman with bacteriuria, suprapubic pain, and fever
c. A young man with dysuria, flank pain, and a previous urinary tract infection
d. An older adult man with a low-grade fever, flank pain, and an indwelling catheter

Question 2

A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past.

What will the nurse tell her?
a. This agent is not effective against infections of the upper urinary tract.
b. This antiseptic agent is safe for use during pregnancy and has no drug resistance.
c. This drug is linked to many serious birth defects and is not recommended during pregnancy.
d. You will need to take this medication with meals to avoid gastric upset.

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

Answer to Question 1

ANS: D
The patient with an indwelling catheter and signs of pyelonephritis shows signs of a complicated UTI, which is best treated with intravenous antibiotics. The other three patients show signs of uncomplicated urinary tract infections that are not severe and can be treated with oral antibiotics.

Answer to Question 2

ANS: A
Methenamine is safe for use during pregnancy and would be an excellent choice for this patient if she had a lower urinary tract infection. However, it is not an effective agent for upper urinary tract infection, because it is a prodrug that must break down into ammonia and formaldehyde to be effective. There is not enough time for formaldehyde to form in the kidneys, so it is not effective in the upper tract. Nitrofurantoin is linked to serious birth defects and also must be given with food to prevent gastrointestinal problems.