A client is in her 16th week of pregnancy. A routine urinalysis has revealed bacteriuria, and the midwife has given the client a prescription for an antibacterial

Question

The client asks why she must take this medication when she has no symptoms of an infection. What is the nurse's best response?
1. "Even though you don't have any symptoms, the infection could keep your baby from gaining enough weight before birth."
2. "I know you don't want to take this medication, but it is safe and will not harm you or your baby."
3. "You are denying your symptoms because you don't want to take the medication."
4. "Taking this medication will prevent your baby from developing kidney damage in the future."

Answer 1

Correct Answer: 1
Rationale 1: Even though the client is asymptomatic, she is treated to prevent the baby from being born with a below-normal weight.
Rationale 2: The medication is probably safe to use and will not harm the baby, but this does not answer the client's question of why she must take the medication.
Rationale 3: This client likely has asymptomatic bacteriuria, which is not uncommon in pregnancy. The client is not denying symptoms.
Rationale 4: This medication is intended to prevent the progression of the bacteriuria to the kidneys, preterm labor, or giving birth to a low-birth-weight baby.
Global Rationale: During pregnancy, the enlarging uterus creates pressure on the urinary bladder, which increases the size of the ureters and promotes urinary stasis and reflux. UTIs in pregnant women are a risk factor for prematurity and newborn low birth weight. The nurse should be prepared to answer the patient's questions and should not imply the patient is denying symptoms. There is no indication that treating bacteriuria in the mother will prevent kidney damage in the infant.