The nurse continues to care for the client.
Which of the following actions should the nurse take? Select all that apply.
Vaginal culture
Obtain provider prescription for antibiotics
Ibuprofen 600 mg every 6 hr for mild to moderate pain
Obtain provider prescription for phenazopyridine
Urine culture
Correct Answer : B,D,E
A. The client’s symptoms (burning with urination, pain) and urinalysis findings are indicative of a urinary tract infection (UTI), which is typically caused by bacteria in the urinary tract. There are no clear indications of a vaginal infection (e.g., discharge, odor, or other symptoms specific to vaginal infections), so a vaginal culture is not needed for this clinical scenario.
B. The client’s symptoms and laboratory results (positive leukocyte esterase, WBC casts, cloudy urine) strongly suggest a UTI, and the elevated WBC count further confirms infection. Antibiotics are the primary treatment for a urinary tract infection. For pregnant clients, it is crucial to select antibiotics that are safe in pregnancy, as untreated UTIs can lead to preterm labor, kidney infections (pyelonephritis), and fetal complications.
C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is generally contraindicated during pregnancy, especially in the third trimester, due to its potential for causing premature closure of the ductus arteriosus, renal complications, and increased bleeding risk. Alternative pain management strategies should be used in pregnancy.
D. Phenazopyridine is a urinary analgesic that can be used to relieve the pain, burning, and discomfort associated with UTIs. However, it is generally not recommended during pregnancy, especially in the first trimester, and should only be used in pregnancy if prescribed by a healthcare provider. There are potential concerns with the safety of phenazopyridine in pregnancy, and it should not be administered without a provider's approval.
E. A urine culture is a diagnostic test that can confirm the presence of a urinary tract infection and
identify the specific bacteria responsible for the infection. Given the client’s symptoms and positive findings on urinalysis, a urine culture should be obtained to help guide the choice of appropriate antibiotics. This will help ensure the effective treatment of the infection and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Hand washing for at least 20 seconds with warm water and soap is recommended to prevent infection, not just 10 seconds.
B. Pregnant women should avoid cleaning the cat's litter box due to the risk of toxoplasmosis.
C. Chickenpox is contagious until all lesions have crusted, so visiting a person with chickenpox is only safe 5 days after the lesions crust over.
D. Antibiotics are not effective for viral infections and should not be taken unless prescribed for a bacterial infection.
Correct Answer is D
Explanation
A. While mental health support can be valuable for the adolescent, the priority is to address the immediate financial and healthcare concerns. Referring to a mental health clinic is not the best first step.
B. Contacting the adolescent's parent may breach the adolescent's confidentiality and autonomy. The adolescent is capable of making her own decisions, and consent from the parent is not necessary unless the adolescent is a minor or unable to make decisions.
C. Advising adoption is a significant decision and should not be presented as a first option. The adolescent should be given the opportunity to explore all of her options with support, including parenting and financial assistance.
D. Assisting the adolescent in applying for Medicaid is an appropriate action as it will provide financial support for medical care, which can help her address concerns about affording and caring for the baby.
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