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NURS 6541 Discussion: Diagnosis and Management of Genitourinary Disorders

NURS 6541 Discussion: Diagnosis and Management of Genitourinary Disorders

 

Additional Questions to Ask

The case study does not address the LOCATES mnemonic. It fails to provide a specific type of condition and the site of the infection for the baby (Maul et al., 2015). Besides, from the medical report availed, it is difficult to establish the attributes of all the symptoms and how they affect the quality of life outcomes for the patient (Klumpp et al., 2017). As such, it will be important to ask additional questions for the healthcare provider to determine the severity of the condition. These questions include;

What is your appetite for food?

Do you experience abdominal pain?

Does your urine have a strong smell?

Do you see blood in your urine?

Additional Examinations or Diagnostic Tests

I will request for renal function tests (RFTs), liver function tests (LFTs) and complete blood count (CBC). The RFTs will help determine the presence or absence of kidney conditions by revealing the electrolyte balance (Chawla et al., 2015). The LFTs, on the other hand, provide an indication of how the liver is working in producing protein as well as clearing bilirubin for the child. Finally, CBC is vital to indicate the number of different components of blood particularly the red blood cells (Kaddourah et al., 2017). The tests correlate directly with genitourinary disorders.

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Differential Diagnosis

The patient is likely to have three conditions. Urinary tract infection (UTI) is the first diagnosis for the patient. This is because

NURS 6541 Discussion Diagnosis and Management of Genitourinary Disorders

NURS 6541 Discussion Diagnosis and Management of Genitourinary Disorders

she exhibits symptoms such as difficulty in urination due to pain which confirms an invasion of the urinary tract system by a pathogen (Klumpp et al., 2017). The child also exhibits signs of acute cystitis. The condition is related to bacterial invasion of the urinary tract system as evidenced by complaints of dysuria.

The third diagnosis is acute kidney injury related to a bacterial infection in the kidney as evidenced by difficulty in controlling urination (Chawla et al., 2015). The patient in the case study recorded frequent episodes of enuresis implying that the possibility of an infection in the kidney cannot be ruled out.

Most Likely Diagnosis

From the case presented, the patient is likely to have acute kidney injury. The condition is related to a decline in renal function as characterized by irregular patterns of urination or pain which may be accompanied by hematuria (Kaddourah et al., 2017). This disorder involves a bacterial infection, shock or injury in the kidney which if not controlled at early stages, may spread into the bladder and affects the urinary tract systems. As from the case study, the patient exhibit symptoms of acute kidney injury which include blood and protein in the urine (Klumpp et al., 2017). The patient also has a past medical history of dysuria and frequent episodes of enuresis which indicates an infection in the kidney.

Treatment

Administer diuretic therapy to increase urine output for the patient. Furosemide 0.5 mg/kg/min will be titrated and administered as an intravenous fluid for the child (Kaddourah et al., 2017). The medication will be monitored for one month to assess prognosis.

Medications will be administered to control blood pressure. Specifically, dopamine 0.5µg/kg per minute will be administered through intravenous routes to improve renal perfusion.

The patient will also receive renal replacement therapy. Specifically, intermittent hemodialysis (HD) is recommended for the child at least once in a week (Kaddourah et al., 2017). This is expected to ensure the elimination of accumulated wastes in the body.

Patient Education, Health Promotion and Anticipatory Guidance

In this case, a conservative diet is recommended for the children. This involves food choices limited in sodium, potassium, and preservative to reduce the severity of the renal condition (Kaddourah et al., 2017). The child should be admitted in the in-patient units to facilitate in the monitoring of the condition. However, upon discharge, a date for revisit need to be two weeks. The child also receives Hepatitis A and Meningococcal immunizations (Reich, 2018). The parents should ensure hygiene to the child to prevent further complications.

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