A patient with a history of renal calculi has fever, flank pain, ...

[natalie2426]

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to:
 
  a. begin antibiotic therapy after urine culture and sensitivity results are available.
  b. give prophylactic antibiotics for 6 weeks after the acute infection has cleared.
  c. initiate immediate treatment with broad-spectrum antibiotics.
  d. refer the patient for intravenous antibiotics and hospitalization.

Question 2

An older male patient comes to the clinic with complaints of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The nurse would most likely suspect that the patient has:
 
  a. acute cystitis.
  b. urinary tract infection.
  c. pyelonephritis.
  d. prostatitis.

[isabelt_18]

Answer to Question 1

ANS: A
Patients with renal calculi are more likely to have complicated urinary tract infections that have less predictable microbiologic etiologies. Because the symptoms are mild, it is important first to obtain a culture and sensitivity to assist with antibiotic selection. If symptoms worsen, a broad-spectrum antibiotic may be started until sensitivity information is available. Intravenous antibiotics are indicated for severe pyelonephritis. Long-term prophylaxis is not indicated unless this patient develops frequent reinfection.

Answer to Question 2

ANS: D
The nurse should suspect prostatitis, which is manifested by high fever, chills, malaise, myalgia, and localized pain and may also be manifested by dysuria, nocturia, and urinary urgency, frequency, and retention. Clinical manifestations of acute cystitis include dysuria, urinary urgency and frequency, suprapubic discomfort, pyuria, and bacteriuria. Urinary tract infections are very general and are classified by their location. Pyelonephritis is characterized by fever, chills, severe flank pain, dysuria, urinary frequency and urgency, as well as by pyuria and bacteriuria.

[natalie2426]

Excellent

[rachel]

TYSM