Question

Shelly is a 4-year-old preschooler who lives with her parents and younger brother. She and her brother attend a local daycare center during the week while their parents are at work. In the evenings she and her brother take a bath and then their parents read to them before bedtime at 8:00 P.M. Shelly's daycare class includes many children her age and she enjoys playing outside with them, Although snack times are planned, Shelly would rather play and does not always finish her beverages,

Shelly's mother calls the pediatric clinic in town and tells the nurse that Shelly has been "running a fever of 101 0 F for the past 2 days' and although her temperature decreases to 37.20 C (990 F) with acetaminophen, it returns to 38.4 C, (1010 F) within 4 hours of each dose. Further, her mother says that Shelly complains that hurts when “I pee-pee." Shelly's mother also has noticed that her daughter seems to be in the bathroom every hour" She makes an appointment to see the pediatrician this afternoon

Questions :

1.     Discuss the significance of Shelly's clinical manifestations.

2.     What other assessment data would be helpful for the nurse to have to prepare Shelly's care plan?

3.     Discuss Shelly's anatomic risk factor(s) for developing a urinary tract infection (UTI)

4.     Discuss the relationship between Shelly’s hygiene habits and her risk for developing a UTI

5.     Discuss how Shelly's level of growth and development places her at risk for developing a UTI.

6.     Shelly's urine culture returns positive for Escherichia coli. 'What is the significance of this finding?

7.     What are the priorities for Shelly's care?

8.     Shelly is prescribed trimethoprim-sulfumethoxazole 60 mg every 12 hours for 10 days. What is this drug and is her prescribed dose safe? Shelly weighs 33 lb.

9.     What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?

10. Shelly is scheduled for a return visit to the clinic in 2 weeks. What is the purpose of this appointment?

Answer 1

1. Discuss the significance of Shelly's clinical manifestations.

Fever ( hyperthermia)

It seems Shelly has fever associated with urinary tract infection .

Painful urination

It is the most common sign of urinary tract infections

Frequent use of bathroom

Due to her discomfort it is usual to feel like peeing very often.

2. What other assessment data would be helpful for the nurse to have to prepare Shelly's care plan?

• Check for dysuria
• Frequency of urination
• Urgency
• Flank pain
• Hematuria
• Fever
• Tenderness

A proper collection of history from her parents is highly recommended to design the care plan for Shelly.

3. Discuss Shelly's anatomic risk factor(s) for developing a urinary tract infection (UTI)

• Female anatomy
• Dehydration
• Improper hygiene
• Diaper allergy

4. Discuss the relationship between Shelly’s hygiene habits and her risk for developing a UTI

• It is evident that she's in day care and she often do not drink her drinks this can lead to dehydration it is the highest risk
• There's a chance of insufficient hygiene that can lead to UTI especially in females