A 46-year-old female patient returns to the clinic with continued dysuria after being treated with trimethoprim and sulfamethoxazole for 3 days. Which action will the nurse plan to take?
Remind the patient about the need to drink 1000 mL of fluids daily.
Obtain a midstream urine specimen for culture and sensitivity testing.
Suggest that the patient use acetaminophen (Tylenol) to relieve symptoms.
Tell the patient to take trimethoprim and sulfamethoxazole for 3 days.
The Correct Answer is B
This is because the persistent dysuria suggests that the initial treatment was not effective, and there may be a possibility of a resistant organism. Obtaining a midstream urine specimen for culture and sensitivity testing will help identify the specific microorganism causing the infection and determine the most effective antibiotic to use. The nurse should also instruct the patient to continue to drink plenty of fluids, as this will help flush out the bacteria and relieve symptoms. The nurse may suggest the use of acetaminophen (Tylenol) to relieve discomfort, but this should not be the only action taken, as treating the underlying infection is crucial. The nurse should not tell the patient to take trimethoprim and sulfamethoxazole for an additional three days, as the initial treatment was not effective, and a different course of treatment may be required based on the results of the urine culture and sensitivity testing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Nausea and vomiting are common symptoms of early pregnancy, and abdominal pain can also occur due to various pregnancy-related conditions. Therefore, it is essential to rule out pregnancy as a potential cause of the patient's symptoms before pursuing other diagnostic options.
Once pregnancy has been ruled out, the nurse can ask additional questions such as those listed in options a, b, and d to further narrow down the potential causes of the patient's symptoms.
Correct Answer is A
Explanation
In acute adrenal insufficiency, also known as Addison's disease, the adrenal glands are unable to produce enough cortisol and aldosterone hormones. These hormones play an important role in regulating sodium and potassium levels in the body. Therefore, a patient with acute adrenal insufficiency may have low sodium and high potassium levels in their blood.
The goal of therapy is to replace the deficient hormones and normalize the electrolyte levels in the body. If the current therapies are effective, the nurse would expect to see an increase in the patient's serum sodium levels because of aldosterone replacement therapy. Therefore, option a is the correct answer.
Decreasing serum chloride levels and decreasing blood glucose levels are not directly related to the treatment of acute adrenal insufficiency. In fact, a patient with acute adrenal insufficiency may have low serum chloride levels and low blood glucose levels due to the lack of cortisol hormone.
Increasing serum potassium levels would be an indicator of ineffective treatment or inadequate aldosterone replacement therapy, as aldosterone helps to regulate potassium levels in the body.
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