A woman goes to the pediatric Eemergency Ddepartment with her four-month old daughter following her pediatrician’s phone recommendation. The infant has been extremely irritable and has not been breastfeeding as usual for the past 24 hours. The mother’s last three attempts to feed the baby were followed by vomiting of whitish, serous fluid. The perinatal history is unremarkable and she received antenatal care. The patient was born by spontaneous vaginal delivery with no complications. Apgar scores were 8, and 9 at 1 and 5 minutes of life. The patient is up to date with her vaccines. Prior to this event, she could raise her chest while lying on her stomach, follow moving objects and smile at the sound of her mother’s voice; she could babble and imitate facial expressions. Physical examination is significant for an ill-looking and irritable …show more content…
Urine culture is generally required to establish a diagnosis of UTI. However, cultures obtained from urine in a sterile bag attached to the perineum have a high rate of false positives hence are not suitable for this purpose.
Choice "C" is not the best answer. Although febrile seizures should be anticipated during febrile illnesses, the priority should be to diagnose and treat the disease that is causing fever to prevent febrile seizures.
Choice “D” is not the best answer. Doxycycline is an antibiotic of the tetracycline class. It is effective against atypical bacteria, such as in chlamydia infections and atypical pneumonia. It Doxycycline is also used against protozoa, such as in early lLyme disease, syphilis, and rickettsial illnesses, but it. It is not effective in for UTIs.
Choice "E" is not the best answer. Imaging studies are not indicated for patients with first episodes of cystitis or without voiding difficulties, abdominal mass, or a prompt response to treatment (72 hours). If a renal and/or bladder ultrasound is indicated, it should be performed after the UTI has been
Kecia is a 25yo, G3 P2002, who was seen for an ultrasound evaluation to evaluate the fetal abdomen. She overall denies any major medical disorders. She reportedly had a seizure related to an anesthesia event in a prior surgery but denies any history of epilepsy and therefore is not on an anticonvulsant. She has 2 previous term uncomplicated vaginal deliveries in 2012 and 2016. On today’s evaluation, overall, she has no obstetrical complaints and has positive fetal movement.
On today’s evaluation, she is 19 weeks and the fetal measurements overall are concordant. The long bone measurements are within one week of her dates. The amniotic fluid volume is normal, and the cervix is long and closed. A complete fetal anatomical survey was performed and a significant amount of ventriculomegaly/hydrocephalous was identified but no other major malformations were noted at this time, though due to the
The four specific databases that were used in this research are, Cinahl, Medline, Joanna Briggs and Cochrane Library. All of these databases were chosen because they provided up to date peer reviewed evidence that was relevant to the search terms. This ensures that the evidence that was found was relevant and reliable. The Cinahl website was useful to gather background information on the topic such as how a UTI is contracted and how it effects the body. The Cochrane Library and Medline website was useful to because it gave specific information on studies that had already been done by other researchers. This helped to ensure that the study that is being undertaken was searching for the right results.
According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).
The child in the most immediate concern is Lydia Pederson. She is now 9 months old and was taken to the hospital via ambulance due to Lydia being limp and unresponsive in the cot. The child was report to be grizzle and unsettled for a few days and the foster carer report that she has had trouble keeping fluid and solids for a few days, and she has had not wet nappies today.
Delievery CS. color is pink with olive undertones, good cry, head normocephalic, fontanelles and sutures WNL. Milia present across nose. Hair is soft, black and sparse. Eyebrows and lashes present, eyes and ears level, nostrils equal, no flaring observed. Sucking pads present. Palate intact, good suck reflex. Eyes bright dark brown, + blink reflex, baby is responsive to sound and movement. Scelera bluish-white. Ears are symmetrical, well-formed. No lesions noted. Clavicles straight and intact. BL lung expansion, Lungs clear BL, no murmurs or thrills noted. Abdomen protruding, umbilical cord dry, no bleeding. Active bowel sounds x 4 quad. No inguinal bulges, femoral pulses +1/4. Buttocks symmetric, anus patent, no dimpling at coccyx. Symmetric
UTI’s is an all too common problem that causes unnecessary distress to patients and delays their recovery during their hospital stay. All healthcare professionals should adhere to these good practice points that could reduce the risk of UTI’s and assure staff that they are demonstrating best practice in their care.
Authors suggested that the accurate diagnosis of a UTI will play a role in the cost-effective medical care and appropriate antimicrobial utilization. The objective of the article is to summarize the top ten, misconceptions of UTI that result in extraneous testing and antimicrobial treatment. This article is well organized, consist of an abstract, introduction, list the myths with mistaken beliefs pertaining to diagnosis, a discussion and conclusion. One reason this article was of an interesting choosing was, due to myth number, “falls and acute altered mental status changes in the elderly patient are usually caused by UTI.” The article suggests that elderly patients with acute mental status changes accompanied by bacteriuria, pyuria without clinical instability or other signs or symptoms of UTI can reasonably be observed for resolution of confusion for 24-48 hours without antibiotics, which searching for other causes. The article describes in detail that elderly patients with acute mental status change and functional decline are nonspecific and are clinical manifestation of several circumstances such as, dehydration, hypoxia, and ploy-pharmacy adverse reaction. In the discussion section, the article also suggests that an increase in education and evidence-based guidelines aimed at physicians, advance practice
Case Presentation: An otherwise healthy 9-month-old boy was brought to the Emergency Department by respite foster parents with a chief complaint of unusual bruises and marks on his skin. Two days prior to the ER visit, the respite foster parents had noticed some left eye redness and swelling, which by day of presentation had progressed to a large swollen blue-black lesion on his left cheek and new scattered bluish lesions on his thighs. The child had been diagnosed with a viral upper respiratory illness three weeks prior and had some lingering nasal congestion with tactile temperatures for the past week, but was otherwise acting very well, eating normally, and was not fussy. His past medical history is remarkable for a pre-term birth at 31 and 5/7 weeks gestation via vaginal delivery. The biological mother’s pregnancy was complicated by premature prolonged rupture of membranes and polysubstance abuse. He was not on any medications and has no known allergies. On physical examination in the ED, his vital signs are within normal limits for age. He is well-appearing and in no acute distress. Head and neck examinations are within normal limits with a soft and open anterior fontanelle. Cardiovascular, pulmonary and abdominal examinations also yield no abnormalities. Skin findings include an obvious large targetoid ecchymosis with underlying edema on the left cheek, a right posterior auricular ecchymosis, as well as several scattered annular blue-black ecchymoses on the bilateral
One of the medical assistant that at the clinic showed me how to do the urine collection including how they conduct their urinalysis in their mini-lab. I find it amazing that they can get a result of the urinalysis in just a few minutes. Once the doctor received the result, she then either made an order for antibiotic or not depending on the test outcome. In my past experience of urine collection at my previous workplace, which was in a long-term care facility, the results for a complete urinalysis were not available until the next day or two. This was new and interesting to me as I have not seen it before. Having the results readily available sped up the process as it was crucial for the doctor to prescribe anything or plan the next step for the
Patient EM is a 5yrs 7months healthy looking young girl that presented to our clinic with her grandmother today. Grandmother states that her birth was uneventful. She was a normal delivery and has been growing well without any special health issues. She states that she has never been hospitalized but do have occasional runny nose and cough. She states that patient is up to date with her immunizations. Grandmother states that patient is in kindergarten and is doing well in school. She states that patient migrated from Puerto Rico few months back and seems to be adjusting ok. Grandmother states that she thinks that she meets all the milestones appropriate for her age. Grandmother state that patient is a picky eater but likes to eat fresh vegetables.
UTI stands for urinary tract infection, and it is an infection that occurs in kidneys, urethra, ureters, bladders, and any other part of urinary system in the body. According to the National Healthcare Safety Network (NHSN), UTIs are proven to be the most common type of health care-associated infection. Among UTIs acquired in the hospital, approximately 75% of patients are associated with catheter, and around 15-25% of them receive urinary catheter when they are in hospital (Centers for Disease Control and Prevention,
The epidemiological rationale for this teaching is that “nearly 1 in 3 women will have had at least 1 episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UTI during their lifetime” (Foxman, 2003). According to Robichaud and Blondeau (2008), in the community setting, the rate of Urinary tract infection accounts for 24% of all diagnosed infections, followed by respiratory tract infections. It is the most common infection reported in long term care facilities too. I also choose this topic because i take care of kids who have also been treated of UTI which also reoccurs.
The mother stated that the child complained of nausea at 10 o’clock the 2nd day of February, later, the child began vomiting and having multiple episodes of diarrhea, she was not able to eat or drink anything without vomiting. As it approached evening, the woman took the child to the local hospital where she
Urinary Tract Infections (UTI’s) are responsible for nearly 10 million health care office visits, 1.5 million hospitalizations and $1 billion in costs annually in the United States, according to the National Kidney Foundation. Millions of the people, who ever suffered from UTI, experience the recurrent bladder infection. Moreover, after the first infection, some people get a second, third and fourth or more UTIs, with each successive infection making them more susceptible to recurrent episodes. Scientists have found that the reason for this is the bacteria, which stays in the inner layers of the bladder and quietly hide from antibiotics used to treat the primary infection of the bladder. As antibiotics don’t get rid of bacteria populations