Chapter 89
Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A. A patient with an uncomplicated urinary tract infection caused by Escherichia coli B. A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C. A patient with acute cystitis who complains of dysuria, frequency, and urgency D. A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia
Answer: B Rationale: Severe pyelonephritis requires intravenous antibiotic therapy.
Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A. A female patient with acute pyelonephritis B. A male patient with acute prostatitis C. A female patient with recurring acute urinary tract infections D. A male patient with acute cystitis
Answer: C Rationale: Female patients with relapses of urinary tract infection may need long-term therapy up to 6 months with trimethoprim/sulfamethoxazole.
Which drug does the nurse identify as a urinary tract antiseptic? A. Ciprofloxacin B. Ceftriaxone C. Nitrofurantoin D. Ceftazidime
Answer: C Rationale: Two urinary tract antiseptics currently are available: nitrofurantoin and methenamine. Ciprofloxacin, ceftriaxone, and ceftazidime are antimicrobials.
1 contradiction for methenamine
renal and liver failure patients.
Therapeutic uses of methenamine?
chronic lower UTI's (TMP/SMZ is the preferred drug)
How does Methenamine work?
decomposes into ammonia and formaldehyde which denature bacterial proteins
6 adverse effects of nitrofurantoin
gastrointestinal effects pulmonary reactions hematologic effects peripheral neuropathy hepatotoxicity birth defects
two drugs that are urinary tract antiseptics
nitrofurantoin methenamine
treatment of choice for UTI
trimethoprim/sulfamethoxazole (TMP/SMZ)