A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI).
Exhibit 1
Exhibit 2
Exhibit 3
The nurse is planning care for the client.
For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
Nurses’ Notes
0700:
7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child’s guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor.
A.
Administer salicylic acid for pain and fever.
B.
Administer sulfamethoxazole and trimethoprim.
C.
Educate the child about proper perineal hygiene.
D.
Advise child’s guardian about the use of sunscreen.
The Correct Answer and Explanation is :
For the 7-year-old child with a urinary tract infection (UTI), let’s evaluate each of the proposed interventions:
A. Administer salicylic acid for pain and fever.
Anticipated: This intervention is contraindicated. Salicylic acid is not appropriate for treating pain and fever in children. The primary concern here is that salicylic acid is not commonly used for these purposes in pediatrics. More importantly, medications containing salicylates, like aspirin, are generally avoided in children due to the risk of Reye’s syndrome, a serious condition that can cause liver and brain damage. Instead, for pain and fever, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) would be more appropriate and safer options for managing these symptoms in children.
B. Administer sulfamethoxazole and trimethoprim.
Anticipated: This intervention is appropriate. Sulfamethoxazole and trimethoprim, often combined as Bactrim or Septra, are commonly prescribed antibiotics for treating UTIs in children. This combination is effective against many of the bacteria that cause UTIs. It works by inhibiting bacterial folic acid synthesis, thus preventing bacterial growth. It is essential to follow the prescribed dosage and complete the full course of antibiotics to ensure the infection is fully eradicated and to prevent resistance.
C. Educate the child about proper perineal hygiene.
Anticipated: This intervention is appropriate. Educating the child about proper perineal hygiene is crucial in managing and preventing UTIs. Proper hygiene includes wiping from front to back to avoid transferring bacteria from the anal area to the urethra. Teaching the child to keep the perineal area clean and dry can help prevent further infections and complications. This education should be age-appropriate, considering the child’s understanding and ability to follow hygiene practices.
D. Advise the child’s guardian about the use of sunscreen.
Contraindicated: This intervention is not directly relevant to the current situation. While sunscreen is important for protecting the skin from harmful UV rays, it does not address the immediate needs of a child with a UTI. The priority should be on managing the UTI through appropriate medications, hygiene education, and symptom relief. Advising about sunscreen is more relevant for general skin protection and would not impact the treatment or management of a UTI.
Summary: For the management of a UTI in a 7-year-old, it is essential to administer appropriate antibiotics, educate on hygiene practices, and avoid contraindicated treatments. Using medications like acetaminophen or ibuprofen for pain and fever is safer than salicylic acid, and advising on sunscreen is not pertinent to the current infection management.