Urinary Tract Infection (UTI).

Urinary Tract Infection (UTI).

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PEER 1

YArlie

Shelly, a 4-year-old child mentioned in this case study is primarily been diagnosed with Urinary Tract Infection (UTI). Apart from fever and other visible signs such as frequent and painful urination, the other assessment data that are required for the diagnosis of UTI is the positive urinalysis, and the urine culture tests. Urinalysis is performed to identify the presence of blood cells, bacterial cells or pus cells in the urine whereas the urine culture tests are performed in order to identify the presence of the causative organism of UTI in the urine sample (Patel, Soni, Bhagyalaxmi, & Patel, 2019).

The most predominant causative organism responsible for the cause of UTI is the Gram-negative anaerobic Escherichia coli. The other bacterial organisms causing UTI are Klebsiella, Enterobacter, Proteus, and Staphylococcus species. Apart from these bacterial species, certain fungal organisms are also responsible for the cause of UTI (Patel et al., 2019). Considering the safety concerns to avoid adverse drug conditions when prescribing for children, the pharmacological treatment recommended for Shelly is the oral intake of trimethoprim-sulfamethoxazole (Bactrim, Septra). The recommended dose for Shelly is 40 mg/kg sulfamethoxazole and 8 mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours for 10 days (Lashkar & Nahata, 2018). This initial antimicrobial drug is considered to be safe and effective for young children as a long-term prophylactic drug therapy against the UTI (Lashkar & Nahata, 2018).

Prior to discharge from the clinic, Shelly and her mother were educated with prescribed medications, its importance in treating the infection and its consequence on discontinuing the course. They were also advised in completing the full course of the medication even if the symptoms were found to be reduced after the oral intake of the drug for few days. They were informed on the importance of hygiene, proper toilet training, and maintaining cleanliness after each bowel movement in order to prevent the germs from entering into the urethra from the anal region. Shelly was also recommended to empty her bladder whenever she urges to urinate as holding the urine for a long time creates more bacterial infection in the urinary bladder (Shaikh & Hoberman, 2019).

PEER 2 Nathalia

1. The nurse needs to familiarize with the history of symptoms exhibited by Shelly. For instance, the nurse needs information on the young girl’s urine color. Urine concentration and description of cloudiness are equally relevant assessment factors because she already knows there is increased volume and urgency (Masika & Armstrong, 2017). Hourly visits to the bathroom are a critical indicator that there could be a urinary tract infection (UTI) but additional assessment details such as odor would provide further information to help assess gravity, diagnosis and subsequent care and treatment.