A patient who has had two recent urinary tract infections is in the clinic with dysuria and fever. The primary care NP reviews the patient's chart and notes that in both previous cases the causative organism and sensitivity were the same
The NP should: a. treat the patient empirically without a culture.
b. order a microscopic evaluation of the urine and an antibiotic.
c. order a urine culture and treat empirically pending culture results.
d. order a urine culture and sensitivity and wait for results before treating.
C
Because this patient has had similar infections in the past, treating empirically is acceptable. The NP must still obtain a culture and sensitivity so that appropriate antibiotic therapy can be provided, even though it is likely that this is a recurrence of the same organism. A culture should always be obtained when possible. A microscopic evaluation is used to determine whether or not a culture should be performed and is not diagnostic.
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