Nokea
A nurse is conducting an in-service presentation for a group of nurses about UTIs and hospitalized clients. When discussing preventive measures, the nurse would identify which of the following as the primary nursing intervention for prevention?
- A. Proper perineal hygiene
- B. Use of urinary acidifiers
- C. Hand hygiene
- D. Routine urinalysis
Correct Answer: C
Rationale: UTIs may affect the hospitalized client or nursing home resident with an indwelling catheter or a disorder such as a stone in the urinary tract. The primary nursing intervention to prevent UTIs in the hospitalized client is good hand hygiene or handwashing. Proper perineal hygiene may be helpful but not as effective as hand hygiene. The use of urinary acidifiers is appropriate to maintain pH of the urine but not prevent UTIs. Routine urinalysis would help identify potential infections but not prevent them.
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A nurse is caring for a client receiving fosfomycin for the treatment of an acute bacterial UTI. Which of the following interventions should the nurse include in the teaching plan for the client about this drug?
- A. Ensure that the drug is administered every 3 hours.
- B. Administer the drug after dissolving it in 90 to 120 mL of hot water.
- C. Ensure that the drug is administered immediately after mixing with water.
- D. Administer the drug on an empty stomach.
Correct Answer: C
Rationale: The nurse should instruct the client to take the drug immediately after mixing it with water. The nurse need not instruct the client to take the drug at an interval of 3 hours, to take the drug after dissolving it in 90 to 120 mL of hot water, or to take the drug on an empty stomach. Fosfomycin, which comes in dry form, should be dissolved in 90 to 120 mL water, but not hot water. The nurse should instruct the client to take the drug with food to prevent gastric upset, which occurs with the administration of fosfomycin.
A nurse is caring for a client receiving methenamine as outpatient treatment for chronic bacterial UTIs. Which instruction should the nurse include in the teaching plan for the client about the administration of the drug?
- A. Avoid prolonged exposure to sunlight.
- B. Increase the intake of milk products.
- C. Avoid an excessive intake of citrus fruits.
- D. Take the drug preferably with food.
Correct Answer: C
Rationale: The nurse should instruct the client taking the anti-infective methenamine to avoid an excessive intake of citrus fruits. The nurse need not instruct the client taking methenamine to avoid prolonged exposure to sunlight, to increase the intake of milk products, or to take the drug preferably with food. Instead, the nurse should instruct the client to avoid milk and milk products when the client is taking methenamine.
After teaching a client about her prescribed anti-infective therapy for her UTI, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I can stop the drug once my symptoms disappear.
- B. I can take the medication with food or meals.
- C. I can drink pineapple juice to keep things acidic.
- D. I'll call my primary health care provider if I don't feel better in about 3 days.
- E. I should avoid drinking any beverages that contain alcohol.
Correct Answer: B,D,E
Rationale: The client should complete the full course of therapy even with symptom relief to ensure that all bacteria have been eliminated from the urinary tract. The client should take the drug with food or meals. Cranberry juice, prune juice, and water are recommended. Alcohol and citrus juices such as orange or pineapple juice are to be avoided. The client should notify her primary health care provider if the symptoms do not subside within 3 to 4 days.
A nurse is developing a teaching plan for a client diagnosed with a UTI and prescribed nitrofurantoin (Macrodantin). The nurse would warn the client about which of the following common gastrointestinal adverse reactions? Select all that apply.
- A. Anorexia
- B. Ileus
- C. Toxic megacolon
- D. Nausea
- E. Diarrhea
Correct Answer: A,D,E
Rationale: Common gastrointestinal adverse reactions seen with the use of nitrofurantoin (Macrodantin) include anorexia, nausea, vomiting, diarrhea, and abdominal pain.
When describing the use of anti-infectives to treat urinary tract infections, which of the following would the nurse identify as the most common structure affected?
- A. Bladder
- B. Kidney
- C. Prostate gland
- D. Urethra
- E. Ureters
Correct Answer: A
Rationale: The urinary tract consists of the following anatomic structures: kidneys, ureters, bladder, prostate gland, and urethra. UTIs most commonly affect the bladder.