K. N. is a 24 y. o. woman who presents to the clinic complaining of sudden urgency to urinate, frequent urination, and pain with urination. Symptoms began approximately 48 hours ago. She awoke from sleep with urgency and suprapubic discomfort two nights ago. Her urine now has a strong odor and a cloudy appearance. She has no fever. History:

UTI at 30,14, and 8 months ago
Iron deficiency anemia
Gonorrhea and chlamydia 2 years ago
Denies tobacco use
Social alcohol and marijuana use
Sexually active with multiple partners
On Phenazopyridine, Ortho-Novum, and Ferrous sulfate
Allergy â to Trimethoprim-Sulfamethoxazole combination â hives with pruritus
Clinical Manifestations
BP 100/60 Pulse 74 Resp. Rate 15 Temperature 98.2
WBC 6,400 Urinalysis â SP 1.035 pH 5.5 Positive for Leukoesterase, Nitrites, and E. coli, trace blood
Diagnosis?
Treatment
-Use of Fluroquinolones and nitrofurantoin

What is the relationship between Nitrites and E. coli?

Diagnosis: The presence of nitrites in the urine confirms the urinary tract infection.

Explanation:

Treatment: The urinary tract infection will be concerned with the antibiotic therapy to kill the bacteria producing excess nitrites. Educating K.N. about the risk factors associated with the multiple sex partners and transfer of bacteria through sexual contact.

Use of fluroquinolones and nitrofurantoin:

Fluroquinolones: This is an antibiotic which has bacteriocidal property can be useful in the treatment of urinary tract infections.

Nitrofurantoin: It is an effective antibiotic in killing bacteria it gets activated inside the bacteria.

Nitrituria is a condition in which the nitrites are present in the urine that is indicative of the presence of bacterial infection. It is caused by the E. coli bacteria inside the urinary tract. It is responsible for converting the nitrates into nitrites.

what subject is this

when you breathe in, or inhale, your diaphragm contracts (tightens) and moves downward. this increases the space in your chest cavity, into which your lungs expand. the intercostal muscles between your ribs also enlarge the chest cavity. they contract to pull your rib cage both upward and outward when you inhale.