Question

I. Read Chapters 44 and 45 from your Textbook

II. NCLEX REview Questions Chapters 44 and 45 from Evolve Resources

III. Urinary Tract Infection

Lilly is a 3-year-old girl who has had abdominal pain and fever since yesterday.

Subjective Data

Lily is complaining of lower abdominal pain.

She has had fever for 24 hours.

Lilly wet her pants, despite being recently potty trained.

Objective Data

Vital signs: temp, 38.5º C; pulse, 114 bpm; resp, 32 breaths/min; blood pressure, 104/62 mm Hg

Urine analysis is positive for white blood cells (WBCs), nitrites, and blood.

Questions:

What risk factors does Lilly have for a urinary tract infection (UTI)?

What might prevent Lilly from a recurring UTI?

What actions should the nurse take in this situation? Prioritize the actions.

Answer 1

ANSWER :

1) Risk factor lilly had for UTI :

• Lilly wet her pants , despite recently being potty trained.
• Improper hygiene of genital region can lead to UTI

2)Prevention of recurrent UTI :

• Increase oral fluid intake of the child : increases renal blood flow and decreases the concentration of urine and flushes out the infection
• Maintaining proper hygiene : keeping genital region clean , wiping from front to back after urination and passing stools and wearing cotton panties prevents recurrent UTI
• Encourage the child to void urine frequently and not to hold it back because stasis of urine leads to bacterial growth and UTI.
• Avoid constipation by giving high fibre diet because hard stools also cause UTI
• Prophylactic low dose antibiotics given to prevent recurrent UTI

3)Nursing intervention :

• As lilly is having high grade fever since 24 hrs , tachycardia , lower abdomen pain and elevated wbc in urine indicating sepsis, she should be admitted immediately
• IV fluids should be given to decrease the concentration of urine
• IV antibiotics : Amoxicillin and clavulanic acid or ,cephalosporins , or Trimethoprim/ Sulfamethoxazole should be given
• Pain relieving medication should be given
• Cold sponging for fever
• Monitor temperature , vitals and frequency of urination
• Urine culture to be sent before starting antiobiotics