Nokea
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.
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After nitrofurantoin is administered to a client with an acute bacterial UTI, assessment reveals dyspnea, chest pain, cough, fever, and chills. Which of the following actions would be most appropriate?
- A. Monitor client for tightness of the chest.
- B. Offer fluids to the client at regular intervals.
- C. Provide oxygen support to the client.
- D. Withhold the drug and contact the primary health care provider.
Correct Answer: D
Rationale: The nurse should immediately notify the primary health care provider and withhold the next dose of the drug until the client is seen by the primary health care provider if acute pulmonary reactions are observed in the client. The nurse should monitor the client for signs of a nonproductive cough or malaise, which may indicate a chronic pulmonary reaction, which may occur during prolonged therapy. Tightness of the chest is not known to occur in the case of a chronic pulmonary reaction, so the nurse need not monitor the client for this. The nurse offers fluids at regular intervals to elderly clients who develop decreased thirst sensation as an adverse reaction to the urinary tract anti-infectives.
A client with a UTI is experiencing dysuria. The nurse would expect which of the following to be prescribed?
- A. Nitrofurantoin (Macrodantin)
- B. Oxybutynin (Ditropan)
- C. Sulfamethoxazole/trimethoprim (Bactrim)
- D. Phenazopyridine (Pyridium)
Correct Answer: D
Rationale: Phenazopyridine (Pyridium) is a urinary tract analgesic that is useful in treating dysuria caused by a UTI.
A nurse is to obtain a daily urine pH as ordered. The client would most likely be receiving which of the following anti-infectives for a UTI because they work better in acidic urine? Select all that apply.
- A. Methenamine (Hiprex)
- B. Amoxicillin (Amoxil)
- C. Fosfomycin (Monurol)
- D. Nitrofurantoin (Macrodantin)
- E. Nalidixic (NegGram)
Correct Answer: A,D
Rationale: A daily urine pH level may be ordered by the physician for clients taking methenamine (Hiprex) or nitrofurantoin (Macrodantin) for a UTI because they work better in acidic urine.
When describing the adverse reactions associated with anti-infectives for UTIs, which of the following would the nurse explain as being most common?
- A. Gastrointestinal
- B. Dermatologic
- C. Neurologic
- D. Urologic
Correct Answer: A
Rationale: Although dermatologic reactions such as rash, pruritus, and photosensitivity reactions can occur and neurologic reactions such as dizziness, drowsiness, headache, blurred vision, and weakness can occur, adverse reactions associated with anti-infectives are primarily gastrointestinal in nature.
The nurse is developing a plan of care for a client who is receiving an anti-infective drug for treatment of a UTI. The nurse has identified a nursing diagnosis of Impaired Urinary Elimination. Which of the following would the nurse include?
- A. Encouraging a fluid intake of at least 2000 mL/day
- B. Offering the client orange juice when administering the medication
- C. Monitoring urine output every 1 to 2 hours
- D. Checking the urine pH every 4 hours
Correct Answer: A
Rationale: Encouraging a fluid intake of at least 2000 mL/day would be appropriate. The nurse should offer fluids such as water, cranberry juice, or prune juice rather than orange juice or other citrus or vegetable juices. Intake and output are usually measured every 8 hours, not every 1 to 2 hours. Urine pH measurements would be appropriate if the client was receiving methenamine or nitrofurantoin.