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What is the recommended antibiotic therapy for the treatment of pyelonephritis in pregnancy?

A.

Ciprofloxacin

B.

Ceftriaxone

C.

Amoxicillin

D.

Trimethoprim-sulfamethoxazole (TMP-SMX)

Answer and Explanation

The Correct Answer is B

A. Ciprofloxacin: Ciprofloxacin is a fluoroquinolone, which is contraindicated in pregnancy due to potential adverse effects on fetal cartilage development.

B. Ceftriaxone: Ceftriaxone, a third-generation cephalosporin, is commonly used in pregnancy for pyelonephritis because it is safe and effective against common uropathogens.

C. Amoxicillin: Amoxicillin is not typically the first-line treatment for pyelonephritis because of increasing resistance and less effectiveness against severe infections.

D. Trimethoprim-sulfamethoxazole (TMP-SMX): TMP-SMX is generally avoided in pregnancy, especially in the first trimester (due to neural tube defect risk) and near term (due to kernicterus risk in the newborn).


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Related Questions

Correct Answer is D

Explanation

A. Heart rate of 56/min. Bradycardia (HR <60/min) can indicate magnesium toxicity. Magnesium sulfate can depress the central nervous system, leading to cardiac complications.

B. Urine output of 50 mL in 4 hr. Urine output should be at least 30 mL/hr (120 mL in 4 hours). Oliguria (low urine output) may indicate magnesium toxicity due to impaired renal excretion.

C. Diminished deep-tendon reflexes. Mildly decreased reflexes may be expected with magnesium therapy, but absent or significantly diminished deep tendon reflexes (DTRs) are an early sign of magnesium toxicity.

D. Respiratory rate of 16/min. A respiratory rate of ≥12 breaths/min indicates that the client is not experiencing respiratory depression, a major concern with magnesium sulfate toxicity. Magnesium should be discontinued if respiratory rate drops below 12/min.

Correct Answer is A

Explanation

A. Parity: In GPTAL (Gravida, Parity, Term, Abortions, Living children), "P" refers to parity, which indicates the number of pregnancies carried to 20 weeks or beyond, regardless of outcome.

B. Postpartum: "Postpartum" refers to the period after childbirth and is not part of the GPTAL system.

C. Primigravida: Primigravida refers to a woman who is pregnant for the first time, which is represented by "G" (Gravida) in GPTAL, not "P."

D. Presentation: "Presentation" refers to the fetal part entering the birth canal first (e.g., cephalic, breech) and is unrelated to GPTAL.

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