A 27-Year-Old Woman, Gravida 1 Para 0, at 29 Weeks

question 52

Multiple Choice

A 27-year-old woman, gravida 1 para 0, at 29 weeks gestation comes to the emergency department due to 24 hours of fever and mild nausea.  Two days ago, she developed urinary frequency and urgency.  The patient has had no vomiting or abdominal pain.  Her pregnancy has been complicated by gestational diabetes mellitus that was diagnosed 4 weeks ago and is well controlled with dietary modification.  The patient has no known drug allergies.
On examination, she appears uncomfortable but is in no acute distress.  Temperature is 38.9 C (102 F) , blood pressure is 124/84 mm Hg, pulse is 96/min, and respirations are 18/min.  Mucous membranes are moist.  The lungs are clear to auscultation.  There is mild tenderness to palpation in the suprapubic region but no costovertebral angle tenderness.
Laboratory results are as follows:
A urine culture is obtained.
Which of the following is the most appropriate treatment at this time?

• A)Administer a dose of intravenous ceftriaxone, then discharge on oral cephalexin
• B)Admit for inpatient intravenous ceftriaxone
• C)Admit for inpatient intravenous ciprofloxacin
• D)Discharge on oral nitrofurantoin with outpatient follow-up in a day
• E)Obtain renal ultrasound; if normal, discharge on oral cephalexin

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Definitions:

Nonselling Time

Periods within a salesperson's schedule that are not directly devoted to selling activities, such as administrative tasks or travel.

Sales Call Allocation

The process of planning and distributing sales calls or visits among different territories or customer segments to optimize effectiveness.

Routing

The travel pattern used in working a sales territory.

Travel Pattern

The habitual movement or route taken by an individual or group, often analyzed for planning effective sales and marketing strategies.