A 24-year-old female presents to the walk-in clinic with complaints of increased urinary urgency and a burning sensation during urination, for the past three days

A 24-year-old female presents to the walk-in clinic with complaints of increased urinary urgency and a burning sensation during urination, for the past three days. The patient relates that she has had a urinary tract infection in the past, about age 15, but denies any other problems with her urinary tract since then. She tells you that she recently began a new job as a second-grade teacher in the public school system, which required her to go three to four hours at a time without the opportunity to go to the bathroom, and this was new to her. She has been drinking cranberry juice, which she heard was helpful for UTIs, but it does not seem to have helped alleviate the symptoms. Other than seasonal allergies, which she treats with diphenhydramine, she has no significant medical history. She is a healthy well-nourished adult female. Takes no medications and her only reported drug allergy is to penicillin severe allergic reaction when she was a child). Physical exam findings are as follows: • Vital signs: Temperature 101.3°F, blood pressure 121/79, pulse 74, respirations 15. • Weight: 135 lbs, height 64 inches • Eyes and Ears: Appear normal. • Neck & Lymph Nodes: Thyroid gland symmetrical, no nodules or lymphadenopathy • Chest: Clear to auscultation. • Heart: Regular rate: S, and S2 heart sounds present. • Lungs: Clear to auscultation bilaterally anterior and posterior. • Abdomen: Nontender, no organomegaly. • Genitourinary: Normal external genitalia; no vaginal discharge. • Rectal: No hemorrhoids. • Labs: Blood work: Normal; Urine analysis, results are pending, although specimen collected looked yellow and cloudy in the specimen container. Urine culture: culture positive for Gram-negative rods (E.coli). and sensitivities show: Amoxicillin – S Ciprofloxacinus Ceftriaxone=S • TMP-SMX-R

In addition to the urine being yellow and having a cloudy appearance (macro- examination), would you anticipate any other findings reported with urinalysis(micro- examination)? Based on the above patient information and what you know about the treatment for UT what medication do you anticipate being used to treat the patient’s problem. Please provide dosage, administration instructions, and duration of treatment. Please provide rationale for why the drug identified in question #2 was selected AND provide reason(s) why the other drugs were not considered in this situation. • Amoxicillin • Ciprofloxacin • Ceftriaxone • TMP-SMX How should the nurse educate the patient regarding the medication identified in quest #2?