According to the clinical manifestations that Shelly's mother gives to the nurse practitioner, they are indicative of a possible UTI case. However, other assessments would be integral to help the nurse come up with a confirmed diagnosis. Among other evaluations that the nurse should aim at getting may include the nurse enquiring about the frequency of urination, urgency, presence of blood in urine, whether the child expresses pain in the flank region as well as full blood count to determine whether the white blood cells are high to indicate an infection ( Foxman, 2014). Additionally, urinalysis would also be integral to decide on whether there are pus cells which would indicate an infection, confirming the cause of UTI.
UTI is likely to be caused by a variety of organisms ranging from bacteria, yeast and fungi. However, most of the cases of UTI have been found to be caused by a group of enteric normal flora known as Escherichia coli ( Schlager, 2016). Klebsiella and Proteus spp are also known for causing UTI. Presence of gram-positive bacteria like Staphylococcus and Enterococcus increase the risk of contracting UTI ( Schlager, 2016). Shelly can be put on pharmacotherapy using antibiotics such as amoxicillin, 25mg per kilogram per oral twelve hourly for seven days ( Cohen et al., 2017)
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UTI is a preventable infection, and people must observe some guidelines to protect themselves from contracting it. The following are some of the health messages to give to Shelly and her mother. Shelly's mother should ensure that the hygiene of her daughter is well maintained, encourage her to take a lot of water to teach her on the best way to wipe her after opening bowels (from front to back), the mother should ensure that she does not use soap to clean Shelly's genitalia ( Foxman, 2014). Those are some of the priority teachings to ensure that Shelly does not get UTI again.
References
Cohen, R., Raymond, J., Launay, E., Gillet, Y., Minodier, P., Dubos, F., & Grimprel, E. (2017). Antimicrobial treatment of urinary tract infections in children. Archives de Pédiatrie , 24 (12), S22-S25.
Foxman, B. (2014). Urinary Tract Infection Syndromes. Infectious Disease Clinics of North America , 28 (1), 1–13. https://doi.org/10.1016/j.idc.2013.09.003
Schlager, T. (2016). Urinary Tract Infections in Infants and Children. Microbiology Spectrum , 4 (5). https://doi.org/10.1128/microbiolspec.uti-0022-2016
