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

Ciprofloxacin

Ceftriaxone

Amoxicillin

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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Correct Answer is A

Explanation

A. "You must be feeling scared and powerless." This response acknowledges the client’s emotions, promoting therapeutic communication. It allows the client to express her concerns and helps build trust with the nurse.

B. "Everyone worries about her baby when she's in labor." This response minimizes the client’s concerns and does not directly address her specific feelings or situation.

C. "We have a neonatal unit here that's equipped to handle emergencies." While this is factually correct, it does not acknowledge the client's emotional distress, which is important in therapeutic communication.

D. "Your pregnancy is advanced so your baby should be fine." While 32 weeks is a viable gestational age, it is not guaranteed that the baby will be fine. This response provides false reassurance.

A. Urinary output 40 mL in 2 hr B. Fetal heart rate 158/min C. Reflexes +2 D. Respirations 16/min

Correct Answer is A

Explanation

A. Urinary output 40 mL in 2 hr: Oliguria (urine output < 30 mL/hr) is a sign of magnesium toxicity, which can lead to respiratory depression, loss of reflexes, and cardiac arrest. The kidneys excrete magnesium, and impaired renal function increases toxicity risk. This finding requires immediate action.

B. Fetal heart rate 158/min: A fetal heart rate of 158 bpm is within the normal range (110-160 bpm) and is not a priority concern.

C. Reflexes +2: A +2 reflex response is normal. In magnesium toxicity, reflexes become diminished or absent (+1 or 0), indicating neuromuscular depression.

D. Respirations 16/min: While respiratory depression is a concern with magnesium sulfate, a respiratory rate of 16 breaths/min is within normal limits (12-20 bpm) and does not require immediate intervention. However, monitoring is still necessary.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in preterm labor at 32 weeks of gestation. The client asks the nurse, "Will my baby be okay?" Which of the following responses should the nurse offer?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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