Cystitis and UTI
2. Use the Crede's maneuver to empty the bladder. 3. Encourage frequent emptying of the bladder. 4. Assure adequate fluid intake. Rationale: . 2, 3, 4. Prevention of urinary tract infections includes adequate fl uid intake, urine acidifi cation, frequent emptying of the bladder including the use of the Crede's maneuver if needed. While the nurse should keep the skin clean and dry, this will not prevent urinary tract infections. Keeping urine close to the meatus with a tight-fi tting diaper would increase the risk for infection.
. The nurse is teaching the parents of a child with myelomeningocele how to prevent urinary tract infections. What should the care plan include for this child? Select all that apply. 1. Provide meticulous skin care. 2. Use the Crede's maneuver to empty the bladder. 3. Encourage frequent emptying of the bladder. 4. Assure adequate fluid intake. 5. Use tight-fitting diapers around the meatus.
3. Ciprofloxacin (Cipro®) Rationale: luoroquinolones, such as ciprofloxacin, can cause false-positive urine opiate screens. Amoxicillin (an aminopenicillin) and cephalexin and ceftazidime (cephalosporin) do not interfere with urine testing for opioids.
A 17-year-old female is undergoing a drug screening test for employment. The client tells a nurse collecting the urine specimen of a recent complicated urinary tract infection that was treated with antibiotic therapy. Which antibiotic, if identified by the client, could produce a false positive urine screening test for opioids? 1. Amoxicillin (Amoxil®) 2. Cephalexin (Keflex®) 3. Ciprofloxacin (Cipro®) 4. Ceftazidime (Fortaz®)
2. Frequency and burning on urination. Rationale: The classic symptoms of cystitis are severe burning on urination, urgency, and frequent urination. Systemic symptoms, such as fever and nausea and vomiting, are more likely to accompany pyelonephritis than cystitis. Hematuria may occur, but it is not as common as frequency and burning.
A 24-year-old female client comes to an ambulatory care clinic in moderate distress with a probable diagnosis of acute cystitis. When obtaining the client's history, the nurse should ask the client if she has had: 1. Fever and chills. 2. Frequency and burning on urination. 3. Flank pain and nausea. 4. Hematuria.
3. "A catheter and contrast solution will be inserted into your child's bladder." Rationale: The nurse should inform the parents that a catheter and contrast solution will be inserted into the child's bladder so that the bladder can be visualized on a fluoroscopic monitor while the bladder is filling to see if any liquid flows backward into one or both ureters, a condition known as vesicoureteral (VU) reflux. The test is performed on an outpatient basis, and a parent is allowed to remain in the room with the child during the procedure if the parent wears a lead apron to prevent exposure of vital organs to radiation. While sedation may not be needed, current studies show that the administration of midazolam (Versed®) eases the child's anxiety and does not affect the results of the test.
A 4-year-old child has a history of four urinary tract infections over the past year. A physician orders a children's (pediatric) voiding cystourethrogram (CVUG) to determine the cause of the child's urinary tract infections. When preparing the child and parents for the procedure, which statement by the nurse is most accurate? 1. "Your child will need to stay overnight in the hospital to have this test." 2. "You will not be allowed to stay in the room with your child due to the radiation from the test." 3. "A catheter and contrast solution will be inserted into your child's bladder." 4. "Since this procedure is painless, no sedation is necessary during this procedure."
2. "Your urine may become brown in color." 3. "Increase your fluid intake." Rationale: Clients who are taking nitrofurantoin (Macrodantin) should be instructed to take the medication with meals and to increase their fl uid intake to minimize gastrointestinal distress. The urine may become brown in color. Although this change is harmless, clients need to be prepared for this color change. The client should be instructed to take the full prescription and not to stop taking the drug because symptoms have subsided. The medication should not be taken with antacids as this may interfere with the drug's absorption.
A client has been prescribed nitrofurantoin (Macrodantin) for treatment of a lower urinary tract infection. Which of the following instructions should the nurse include when teaching the client how to take this medication? Select all that apply. 1. "Take the medication on an empty stomach." 2. "Your urine may become brown in color." 3. "Increase your fluid intake." 4. "Take the medication until your symptoms subside." 5. "Take the medication with an antacid to decrease gastrointestinal distress.
1. Collect the urine in a preservative-free container and keep it on ice. Rationale: All urine for creatinine clearance determination must be saved in a container with no preservatives and refrigerated or kept on ice. The fi rst urine voided at the beginning of the collection is discarded, not the last. A self-report of weight may not be accurate. It is not necessary to have an indwelling urinary catheter inserted for urine collection.
A client has nephropathy. The physician orders that a 24-hour urine collection be done for creatinine clearance. Which of the following actions is necessary to ensure proper collection of the specimen? 1. Collect the urine in a preservative-free container and keep it on ice. 2. Inform the client to discard the last voided specimen at the conclusion of urine collection. 3. Ask the client what his weight is before beginning the collection of urine. 4. Request an order for insertion of an indwelling urinary catheter.
4. Near-term pregnancy Rationale: Sulfamethoxazole, a sulfonamide antibiotic, is a Category D medication for near-term pregnancy. This means there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., for a life-threatening illness or a serious disease for which safer medications cannot be used or are ineffective). History of gastric ulcer or type 1 diabetes does not prevent the use of sulfamethoxazole. A positive urine culture would be an indication for using sulfamethoxazole.
A client is to receive a first dose of oral sulfamethoxazole (Gantanol®) 1 gram every 12 hours for treatment of recurrent urinary tract infections. Which information about the client should prompt the nurse to immediately notify the physician to question the medication order? 1. History of gastric ulcer 2. Type 1 diabetes mellitus 3. Urine culture positive for Escherichia coli 4. Near-term pregnancy
1. Infusing slowly over 60 minutes Rationale: Ciprofloxacin is prescribed for treatment of mild, moderate, severe, and complicated infections of the urinary tract, lower respiratory tract, and skin and skin structure. A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation. Ciprofloxacin is not light-sensitive, may be infused through a peripheral IV access, and is not given by IV push method.
A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action? 1. Infusing slowly over 60 minutes 2. Infusing in a light-protective bag 3. Infusing only through a central line 4. Infusing rapidly as a direct IV push medication
3. "Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose." Rationale: Antibiotics have the maximum effect when a blood level of the medication is maintained. However, because nitrofurantoin (Macrodantin) is readily absorbed from the gastrointestinal tract and is primarily excreted in urine, toxicity may develop by doubling the dose. The client should not skip a dose if she realizes that she has missed one. Additional fl uids, especially water, should be encouraged, but not forced to promote elimination of the antibiotic from the body. Adequate fl uid intake aids in the prevention of urinary tract infections, in addition to an acidic urine
A client with a urinary tract infection is to take nitrofurantoin (Macrodantin) four times each day. The client asks the nurse, "What should I do if I forget a dose?" What should the nurse tell the client? 1. "You can wait and take the next dose when it is due." 2. "Double the amount prescribed with your next dose." 3. "Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose." 4. "Take a lot of water with a double amount of your prescribed dose."
2. "I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible." Rationale: To ensure appropriate psychosocial development, a child needs to have normal patterns maintained as much as possible during illness. It is tempting to give ill children special treatment and to relax discipline. However, family routines and discipline should be kept as normal as possible. The child needs to know the limits to ensure feelings of security. When they are ill, children commonly attempt to stretch the rules and limits. If this occurs, returning to the previous well-behavior patterns will take time
A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We don't want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best? 1. "I sympathize with your difficulties, but just ignore the behavior for now." 2. "I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible." 3. "I understand that things are difficult for you right now, but your child is ill and deserves special treatment." 4. "I understand your concern, but this type of behavior happens all the time; your child will get over it when feeling better.
3. "Continue taking the medication because nitrofurantoin (Furadantin®) discolors the urine." Rationale: Nitrofurantoin (Furadantin®) produces a harmless, brown color to the urine. The medication should be discontinued only after the client's symptoms are alleviated or the prescribed dose is completed. Concentrated urine would be dark amber, not necessarily brown-colored. Medication dosages should not be changed without a physician's order. A urine culture should be performed before treatment is initiated, if treatment is ineffective, and during the follow-up appointment. A urine culture is not indicated at this time. Although increasing fluid intake will lighten the urine color, the urine will remain brown-colored.
A home health client verbalizes concerns about producing brown-colored urine after taking nitrofurantoin (Furadantin®) for a urinary tract infection. Which response by a nurse is most appropriate? 1. "Your urine is too concentrated. Take only one-half the dose of your medication." 2. "Discontinue taking the medication and make an appointment for a urine culture." 3. "Continue taking the medication because nitrofurantoin (Furadantin®) discolors the urine." 4. "Drink 500 mL of fluid every 3 hours to lighten your urine color."
1. "It prevents complete emptying of the bladder." Rationale: The reason that urinary tract infections are a problem in children with vesicoureteral refl ux is that urine fl ows back up the ureter, past the incompetent valve, and back into the bladder after the child has fi nished voiding. This incomplete emptying of the bladder results in stasis of urine, providing a good medium for bacterial growth and subsequent infection. Vesicoureteral refl ux does not cause bladder spasms or painful urination. However, the child may experience painful urination with a urinary tract infection
A nurse is teaching the parents of a child diagnosed with a urinary tract infection secondary to vesicoureteral reflux. How should the nurse explain how the reflux contributes to the infection? 1. "It prevents complete emptying of the bladder." 2. "It causes urine backflow into the kidney." 3. "It results in painful bladder spasms." 4. "It causes painful urination."
2. Encouraging fluid intake Rationale: Cystitis is an infection of the bladder. The client should consume 3000 mL of fluids per day if not contraindicated. Sitz baths and ice would be appropriate interventions for perineal discomfort. Hemoglobin and hematocrit levels would be monitored with hemorrhage.
A postpartum client is diagnosed with cystitis. The nurse should plan for which priority action in the care of the client? 1. Providing sitz baths 2. Encouraging fluid intake 3. Placing ice on the perineum 4. Monitoring hemoglobin and hematocrit levels
1. Abdominal pain. Rationale: Abdominal pain frequently accompanies urinary tract infection in children 2 years of age and older. Other associated signs and symptoms include decreased appetite, vomiting, fever, and irritability. The presence of swollen lymph glands (lymphadenopathy) is unrelated to urinary tract infections. Lymphadenopathy is associated with a systemic infection or possibly cancer. Skin rash is associated with exposure to allergens or irritants (e.g., poison ivy or harsh soaps); prolonged contact with urine (e.g., diaper dermatitis); or illnesses such as measles, rheumatic fever, or juvenile rheumatoid arthritis. Flank or back pain is associated with urinary tract infection in children older than 2 years of age and in adults.
A recent history of which of the following should alert the nurse to gather additional information about the possibility of a urinary tract infection in a 2-year-old child who is exhibiting fever and fussiness? 1. Abdominal pain. 2. Swollen lymph glands. 3. Skin rash. 4. Back pain.
1. eliminating caffeine and tea from her diet. Rationale: Caffeine-containing beverages, such as coffee, tea, and cocoa, and alcoholic beverages irritate the bladder and should be avoided. Showers, rather than tub baths, are recommended. Synthetic underwear and constricting clothing, such as tight jeans, should be avoided. Abstinence is unnecessary. The client should urinate after intercourse.
After completing a health history for a female client experiencing recurrent urinary tract infections (UTI), a nurse determines that the client should be taught to reduce her risk for a UTI by: 1. eliminating caffeine and tea from her diet. 2. taking tub baths rather than showers. 3. wearing good quality synthetic underwear. 4. abstaining from sexual intercourse.
1. Avoid taking ciprofloxacin with milk or yogurt. Rationale: Ciprofloxacin is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided. Bismuth subsalicylate also decreases the absorption of ciprofloxacin and should be avoided. Extended release ciprofloxacin significantly reduces the frequency of nausea and diarrhea. Fennel will decrease the absorption of the ciprofloxacin. Dietary calcium can be taken at any time; it is unaffected by ciprofloxacin.
Ciprofloxacin (Cipro-XR®) is prescribed for a client to treat a urinary tract infection. Which point should a nurse stress when teaching the client about the medication? 1. Avoid taking ciprofloxacin with milk or yogurt. 2. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate (Pepto-Bismol®). 3. Avoid fennel because it will increase the absorption of the ciprofloxacin. 4. Take dietary calcium tablets 1 hour before or 2 hours after ciprofloxacin.
75/25 x 5 X = 15 mL.
Nitrofurantoin (Macrodantin), 75 mg four times per day, has been prescribed for a client with a lower urinary tract infection. The medication comes in an oral suspension of 25 mg/5 mL. How many milliliters should the nurse administer for each dose? ________________________ mL
4. The client is experiencing a pulmonary reaction requiring cessation of the medication. Rationale: Nitrofurantoin can induce 2 kinds of pulmonary reactions: acute and subacute. Acute reactions, which are most common, manifest with dyspnea, chest pain, chills, fever, cough, and alveolar infiltrates. These symptoms resolve 2 to 4 days after discontinuing the medication. Acute pulmonary responses are thought to be hypersensitivity reactions. Subacute reactions are rare and occur during prolonged treatment. Symptoms (e.g., dyspnea, cough, malaise) usually regress over weeks to months following nitrofurantoin withdrawal. However, in some clients, permanent lung damage may occur. The remaining options are incorrect interpretations.
Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which interpretation about the client's complaints? 1. The client may have contracted the flu. 2. The client is experiencing anaphylaxis. 3. The client is experiencing expected effects of the medication. 4. The client is experiencing a pulmonary reaction requiring cessation of the medication.
4. "Foods and fluids that will increase urine alkalinity should be consumed. Rationale: A client with a urinary tract infection must be encouraged to take the prescribed medication for the entire time it is prescribed. The client should also be instructed to drink at least 3000 mL of fluid each day to flush the infection from the bladder and to urinate frequently throughout the day. Foods and fluids that acidify the urine need to be encouraged.
On the second postpartum day, a client complains of burning on urination, urgency, and frequency of urination. A urinalysis indicates the presence of a urinary tract infection. The nurse instructs the client regarding measures to take for the treatment of the infection. Which client statement indicates to the nurse the need for further instruction? 1. "I need to urinate frequently throughout the day." 2. "The prescribed medication must be taken until it is finished." 3. "My fluid intake should be increased to at least 3000 mL daily." 4. "Foods and fluids that will increase urine alkalinity should be consumed.
2. Urination is not painful. Rationale: Phenazopyridine is a urinary analgesic. It is effective when it eliminates pain and burning with urination. It does not eliminate the bacteria causing the infection, so it would not make the urine clear amber. It does not treat urge incontinence. It will cause the client to have reddish-orange discoloration of urine, but this is a side effect of the medication, not the desired effect.
Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation? 1. Urine is clear amber. 2. Urination is not painful. 3. Urge incontinence is not present. 4. A reddish-orange discoloration of the urine is present.
3. 2 tablets Rationale: Change 1 g to milligrams, knowing that 1000 mg = 1 g. Also, when converting from grams to milligrams (larger to smaller), move the decimal point 3 places to the right: 1g = 1000mg
Sulfisoxazole, 1 g orally twice daily, is prescribed for an adolescent with a urinary tract infection. The medication label reads "500-mg tablets." The nurse has determined that the dosage prescribed is safe. The nurse administers how many tablets per dose to the adolescent? 1. ½ tablet 2. 1 tablet 3. 2 tablets 4. 3 tablets
4. An ascending infection from the urethra. Rationale: Although various conditions may result in cystitis, the most common cause is an ascending infection from the urethra. Strictures and urine retention can lead to infections, but these are not the most common cause. Systemic infections are rarely causes of cystitis.
The client asks the nurse, "How did I get this urinary tract infection?" The nurse should explain that in most instances, cystitis is caused by: 1. Congenital strictures in the urethra. 2. An infection elsewhere in the body. 3. Urinary stasis in the urinary bladder. 4. An ascending infection from the urethra.
3. Providing an analgesic effect on the bladder mucosa. Rationale: Phenazopyridine hydrochloride (Pyridium) is a urinary analgesic that works directly on the bladder mucosa to relieve the distressing symptoms of dysuria. Phenazopyridine does not have a bacteriostatic effect. It does not potentiate antibiotics or prevent crystallization.
The client with cystitis is given a prescription for phenazopyridine hydrochloride (Pyridium). The nurse should teach the client that this drug is used to treat urinary tract infections by: 1. Releasing formaldehyde and providing bacteriostatic action. 2. Potentiating the action of the antibiotic. 3. Providing an analgesic effect on the bladder mucosa. 4. Preventing the crystallization that can occur with sulfa drugs.
4. Spend time with the client addressing her concerns and then stay with her while she talks with her husband. Rationale: As newlyweds, the client and her husband need to develop a strong communication base. The nurse can facilitate communication by preparing and supporting the client. Given the situation, an interdisciplinary conference is inappropriate and would not promote intimacy for the client and her husband. Insisting that the client talk with her husband is not addressing her fears. Being present allows the nurse to facilitate the discussion of a diffi cult topic. Having the nurse speak fi rst with the husband alone shifts responsibility away from the couple.
The client, who is a newlywed, is afraid to discuss her diagnosis of cystitis with her husband. Which would be the nurse's best approach? 1. Arrange a meeting with the client, her husband, the physician, and the nurse. 2. Insist that the client talk with her husband because good communication is necessary for a successful marriage. 3. Talk first with the husband alone and then with both of them together to share the husband's reactions. 4. Spend time with the client addressing her concerns and then stay with her while she talks with her husband.
3. "I will get an order for a lidocaine-based lubricant to make the procedure more comfortable." Rationale: 2% lidocaine lubricants have been found to significantly reduce the pain of urinary catheter insertion in children. If the unit does not have a standing protocol to use the lubricant, the nurse should request an order. A sedative would carry with it additional risks that could be avoided with the use of other methods to reduce pain. The parents should be encouraged to hold the child in addition to other pain relief methods. Frequent urination would make the use of topical anesthetics that must be left in place for a period of time impractical.
The health care provider has ordered a sterile urine specimen on a 3-year-old boy with a history of recurrent urinary tract infections. The family is upset because the last time the child was catheterized the procedure was very painful and traumatic. The nurse should tell the family: 1. "I will request an order for a sedative to help him relax." 2. "I can't do anything to reduce the pain, but you can hold him during the procedure." 3. "I will get an order for a lidocaine-based lubricant to make the procedure more comfortable." 4. "I can apply a topical anesthetic 20 minutes before placing the catheter."
4. At least 3,000 mL of fluids daily. Rationale: Instructions should be as specific as possible, and the nurse should avoid general statements such as "a lot." A specifi c goal is most useful. A mix of fluids will increase the likelihood of client compliance. It may not be sufficient to tell the client to drink twice as much as or 1 quart more than she usually drinks if her intake was inadequate to begin with.
The nurse explains to the client the importance of drinking large quantities of fluid to prevent cystitis. The nurse should tell the client to drink: 1. Twice as much fl uid as usual. 2. At least 1 quart more than usual. 3. A lot of water, juice, and other fluids throughout the day. 4. At least 3,000 mL of fluids daily.
1. Fever 3. Complaints of indigestion 5. Pain in the upper right quadrant after a fatty meal Rationale: During an acute episode of cholecystitis, the client may complain of severe right upper quadrant pain that radiates to the right scapula or shoulder or experience epigastric pain after a fatty or high-volume meal. Fever and signs of dehydration would also be expected, as well as complaints of indigestion, belching, flatulence, nausea, and vomiting. Options 4 and 6 are incorrect because they are inconsistent with the anatomical location of the gallbladder. Option 2 (Cullen's sign) is associated with pancreatitis.
The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply. 1. Fever 2. Positive Cullen's sign 3. Complaints of indigestion 4. Palpable mass in the left upper quadrant 5. Pain in the upper right quadrant after a fatty meal 6. Vague lower right quadrant abdominal discomfort
4. Decreased ability to detect thirst. Rationale: The sensation of thirst diminishes in those greater than 60 years of age; hence, fl uid intake is decreased and dissolved particles in the extracellular fl uid compartment become more concentrated. There is no change in liver function in older adults, nor is there a reduction of ADH and aldosterone as a normal part of aging.
The nurse is teaching an 80-year-old client with a urinary tract infection about the importance of increasing fluids in the diet. Which of the following puts this client at a risk for not obtaining sufficient fluids? 1. Diminished liver function. 2. Increased production of antidiuretic hormone. 3. Decreased production of aldosterone. 4. Decreased ability to detect thirst.
1. "Continue taking the medication; the brown urine occurs and is not harmful." Rationale: Nitrofurantoin imparts a harmless brown color to the urine, and the medication should not be discontinued until the prescribed dose is completed. Magnesium hydroxide will not affect urine color. In addition, antacids should be avoided because they interfere with medication effectiveness.
The nurse receives a call from a client concerned about eliminating brown-colored urine after taking nitrofurantoin for a urinary tract infection. The nurse should make which appropriate response? 1. "Continue taking the medication; the brown urine occurs and is not harmful." 2. "Take magnesium hydroxide with your medication to lighten the urine color." 3. "Discontinue taking the medication and make an appointment for a urine culture." 4. "Decrease your medication to half the dose, because your urine is too concentrated."
2. "I will take hot tub baths." Rationale: Hot tub baths promote relaxation and help relieve urgency, discomfort, and spasm. Applying heat to the perineum is more helpful than cold because heat reduces infl ammation. Although liberal fl uid intake should be encouraged, caffeinated beverages, such as tea, coffee, and cola, can be irritating to the bladder and should be avoided. Voiding at least every 2 to 3 hours should be encouraged because it reduces urinary stasis.
The nurse teaches a female client who has cystitis methods to relieve her discomfort until the antibiotic takes effect. Which of the following responses by the client would indicate that she understands the nurse's instructions? 1. "I will place ice packs on my perineum." 2. "I will take hot tub baths." 3. "I will drink a cup of warm tea every hour." 4. "I will void every 5 to 6 hours."
2. Maintain a daily fluid intake of 2,000 to 3,000 mL. Rationale: Maintaining a fl uid intake of 2,000 to 3,000 mL/day is likely to be most effective in preventing urinary tract infection. A high fl uid intake results in high urine output, which prevents urinary stasis and bacterial growth. Avoiding people with respiratory tract infections will not prevent urinary tract infections. Clean, not sterile, technique is used to change the appliance. An ileal conduit stoma is not irrigated.
The nurse teaches the client with an ileal conduit measures to prevent a urinary tract infection. Which of the following measures would be most effective? 1. Avoid people with respiratory tract infections. 2. Maintain a daily fl uid intake of 2,000 to 3,000 mL. 3. Use sterile technique to change the appliance. 4. Irrigate the stoma daily
2. Discontinue the medicine and come for immediate further evaluation. Rationale: Sulfonamides have been associated with severe adverse reactions. A blistering rash may be a sign of Stevens-Johnson syndrome, a severe allergic reaction that manifests as skin lesions. This reaction is life threatening and requires immediate attention. Lotion should not be applied to skin with blisters. Bactrim may cause photosensitivity, but this usually appears as a mild red rash, not blisters. Increasing the child's fluid intake may help the urinary tract infection, but does not address the rash.
The parents of a child on sulfamethoxazole and trimethoprim (Bactrim) for a urinary tract infection report that the child has a red, blistery rash. The nurse should tell the parents to: 1. Apply lotion to the affected areas. 2. Discontinue the medicine and come for immediate further evaluation. 3. Use sunblock while on the medication. 4. Increase the child's fluid intake.
1. Wearing cotton underpants. Rationale: A woman can adopt several health promotion measures to prevent the recurrence of cystitis, including avoiding too-tight pants, noncotton underpants, and irritating substances, such as bubble baths and vaginal soaps and sprays. Increasing citrus juice intake can be a bladder irritant. Regular douching is not recommended; it can alter the pH of the vagina, increasing the risk of infection.
To prevent recurrence of cystitis, the nurse should plan to encourage the female client to include which of the following measures in her daily routine? 1. Wearing cotton underpants. 2. Increasing citrus juice intake. 3. Douching regularly with 0.25% acetic acid. 4. Using vaginal sprays.
2. Encourage the child to drink plenty of fluids. 4. Administer the medication at the prescribed times. 5. Continue the medication until the full prescription is gone. 6. If a rash should occur report this immediately to the health-care provider. Rationale: Fluids should be increased to dilute bacterial toxins and increase urinary output. The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. If the full prescription is not taken, the infection may return. Trimethoprimsulfamethoxazole is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides. Weighing is unnecessary; it is important with medications that affect fluid balance. Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications.
Trimethoprim-sulfamethoxazole (TMP-SMZ or Bactrim®) is prescribed for a 6-year-old child who develops a urinary tract infection (UTI). Which points should a nurse address when teaching the parents about administering the medication? SELECT ALL THAT APPLY. 1. Weigh the child daily. 2. Encourage the child to drink plenty of fluids. 3. Take the child's temperature daily. 4. Administer the medication at the prescribed times. 5. Continue the medication until the full prescription is gone. 6. If a rash should occur report this immediately to the health-care provider.
1. Bright orange-red urine. Rationale: The client should be told that phenazopyridine hydrochloride (Pyridium) turns the urine a bright orange-red, which may stain underwear. It can be frightening for a client to see orange-red urine without having been forewarned. Other common adverse effects associated with phenazopyridine include headaches, gastrointestinal disturbances, and rash. Phenazopyridine does not cause incontinence, constipation, or drowsiness.
When teaching the client with a urinary tract infection about taking phenazopyridine hydrochloride (Pyridium), the nurse should tell the client to expect: 1. Bright orange-red urine. 2. Incontinence. 3. Constipation. 4. Slight drowsiness.
1. "I can usually go 8 to 10 hours without needing to empty my bladder." Rationale: Stasis of urine in the bladder is one of the chief causes of bladder infection, and a client who voids infrequently is at greater risk for reinfection. A tub bath does not promote urinary tract infections as long as the client avoids harsh soaps and bubble baths. Scrupulous hygiene and liberal fl uid intake (unless contraindicated) are excellent preventive measures, but the client also should be taught to void every 2 to 3 hours during the day
Which of the following statements by the client would indicate that she is at high risk for a recurrence of cystitis? 1. "I can usually go 8 to 10 hours without needing to empty my bladder." 2. "I take a tub bath every evening." 3. "I wipe from front to back after voiding." 4. "I drink a lot of water during the day."
