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Genitourinary Disorder Alteration In Fluid Elimination Uti

1598 words - 6 pages

Genitourinary Disorder Alteration in Fluid Elimination UTI
Urinary Tract Infection (UTI) is a bacterial infection that affects the various parts of the urinary system such as the urethra, bladder, ureters, and kidneys. In young children, this disease is common and potentially serious. Statistics show that approximately 1% of boys and 3-5% of girls are affected by UTI. While most cases of UTI in boys usually occur within the first year, the age at which the first case of UTI is diagnosed in girls varies greatly. There are many factors that predispose young children to UTI including vesicoureteral reflux (VUR), incomplete emptying of the bladder, sexual abuse, pinworms, and fecal incompetence (Berreman, 2002). Correct diagnosis of UTI is paramount in order to avoid prescribing the wrong medication. In addition, correct diagnosis is critical in developing effective management and care plans for the patient which would go a long way in improving patient outcomes.
During diagnosis, various diagnostic methods are used and the patient’s medical history as well as signs and symptoms ought to be a central focus by the clinician. This is important because as opposed to the more clear symptoms in older children and adults, UTI symptoms tend to be less specific and thus hard to detect in young children and infants. In fact, fever may turn out to be the only sign pointing to the possible presence of UTI in infants. In this case study, a case of UTI in a four month old female is examined with a special focus on the medical history, signs and symptoms, diagnosis, etiology, treatment, and management and care of the patient.
Medical history and physical assessment of the patient
A female infant aged 4 months presents with chief complaint of vomiting, loose stools, and fever. Medical history indicates that she had 5-6 instances of emesis during the first day that the illness was noted and tactile fever that has lasted for 3 days. 2 days ago, the examination at the emergency room gave the impression of gastroenteritis. However, no x-rays or lab tests were done in the emergency room. Now she has returned to the office with persistent fever being the chief complaint after diarrhea and vomiting having resolved. In addition, her breast-feeding is not encouraging and her mother reveals that her child has become less playful besides her urine having a strong smell. The child has had no ill contacts that the mother is aware of; she has no URI symptoms, cough, or even rash. She has also not been on any medication and her past history seems remarkable (Berreman, 2002).
Physical examination reveals T=38.9 degrees Celsius, Wt=5.3 kg which is 150mg lower than her weight before illness, R=40, P=164. The infant is active, smiling, alert, in no distress, and not toxic. She has normal ENT and eye exams, regular heart rate without murmurs, her neck is supple, she has a flat and soft anterior fontanelle, moist oral mucosa, flat, non-tender, and soft abdomen...

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