1. A 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. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the
symp- toms.: Answer: b. Obtain a midstream urine specimen for
culture and sensitivity testing.
Since 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. Tylenol 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.
Since the UTI has persisted after treatment with Bactrim, the patient is
,likely to need a different antibiotic.
2. The nurse determines that instruction regarding prevention of future uri-
nary tract infections (UTIs) for a patient with cystitis has been effective
when the patient states,
a. "I can use vaginal 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.": Answer: d.
"I will empty my bladder every 3 to 4 hours during the day."
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.
3. Which information will the nurse include when teaching the patient with
a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)?
,a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
c. The urine may turn a reddish-orange color.
, d. Use the Pyridium before sexual intercourse.: Answer: c. The urine may
turn a reddish-orange color.
Patients should be taught that Pyridium will color the urine deep
orange. Urinary analgesics should only be needed for a few days until
the prescribed antibiotics decrease the bacterial count. Taking Pyridium
before intercourse will not be helpful in reducing the risk for UTI.
Pyridium does not cause photosensitivity.
4. A 72-year-old who has benign prostatic hyperplasia is admitted to the
hospital with chills, fever, and vomiting. Which finding by the nurse will
be most helpful in determining whether the patient has an upper urinary
tract infection (UTI)?
a. Suprapubic pain
b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness: Answer: d. Costovertebral tenderness
Costovertebral tenderness is characteristic of pyelonephritis. The other
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