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

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

5) *THE GIRLS AGES 2-6 YEARS ARE THE HIGHER RISK GROUP OF UTI DUE TO SHORT URETHRA. * IN DAY CARE FACILITY LACK OF ATTENTION OF CHILD IS LESSER THAN HOME CARE. BECAUSE OF LOTS OF CHILDREN WITH DIFFERENT EATING AND DRINKING PATTERN. * THERE IS PRESENCE OF SAME AGE GROUP HAVE TENDENCY TO MORE PLAY THAN MEALS TIME. * IN DAY CARE ALL CHILDREN ATE USE SINGLE TOILET IT WILL CAUSE DEVELOPMENT OF UTI. * IMPROPER CLEANING AFTER DEFECATION IS DUE TO CHILD IS UNABLE TO CLEAN PROPER TECHNIQUE; CLEAN FROM URETHRA TO ANAL AREA. * IN THEIR HOME , THE PARENTS ARE BUSY PERSONS, THEY HAVEN'T ENOUGH TIME TO MANAGE WITH PROPER HYDRATION AND HYGIENE. 6) *E. COLI ARE HARMLESS AND IN GENERALLY SEEN IN INTESTINAL TRACT. * BUT IT WILL COME OUTSIDE DURING DEFECATION IT WILL CAUSE UTI MORE CHANCE TO GET UTI IN GIRLS DUE TO SHORT URETHRA. 7)* ACUTE PAIN RELATED TO INFECTIOUS PROCESS ( GIVE ANALGESIC AS PER DOCTORS ORDER) * HYPERTHERMIA RELATED TO INFECTIOUS PROCESS. ( GIVE TAPID SPONGE TO REDUCE TEMPERATURE, CHECK VITAL SIGNS, GIVE ANTIPYRETICS AS PER DOCTORS ORDER) * IMPAIRED URINARY ELIMINATION RELATED TO INFECTIOUS PROCESS. ( PROVIDE ORAL FLUID TO INCREASE URINARY ELIMINATION, MAINTAIN INTAKE AND OUTPUT CHART) * INSOMNIA RELATED TO DISEASE CONDITIONS. ( AVOID VISITORS, PAIN MANAGEMENT) 8) IT IS AN ANTIBIOTICS FOR TREAT UTI. THE DOSE FOR CHILDREN 8Mg/ kg is normal. Prescribed dose= 60 mg twice daily=20mg in the child have need the dose= 8×14.969(33 lb) approximately 120 it is safe.