2. What are the organisms most likely to cause an UTI?

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 PM. 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 clinic and tells the nurse practitioner that Shelly  has been “running a fever of 101 F for the past 2 days” and although her  temperature decreases to 37.2 C (99 F) with Tylenol, it returns to 38.4  C (101 F) within 4 hours of each dose. Further, her mother says that  Shelly complains that “it 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 nurse practitioner this afternoon.

The potential diagnosis is UTI.

1. What other assessment data would be helpful for the nurse practitioner to have?

2. What are the organisms most likely to cause an UTI?

3. What is the pharmacological treatment for Shelly? Keep in mind safe dosing.

4. What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?

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