After analyzing the symptoms and the results of diagnostic tests, one can suggest that the patient has a urinary tract infection (UTI). UTIs are characterized by painful urination or the inability to urinate (Flores-Mireles, Walker, Caparon, & Hultgren, 2015). Moreover, the urine of a person with a UTI is often cloudy and contains blood. In order to confirm this diagnosis and assess risks, the clinician should ask the patient about her previous kidney or bladder infections.
The patient’s temperature should be taken to detect complications and avoid a severe kidney infection (Shaikh et al., 2016). The patient’s glucose is negative which implies that diabetes may be excluded from possible causes. Next, one should inquire about the patient’s sexual activity – last intercourse, pain during intercourse, the possibility of pregnancy, types of contraception. If the patient had a condition where a catheter was used, this might also be a cause of the infection.
Goals and Drug Treatment
The primary treatment goal for the patient is to eliminate the bacteria which cause the UTI. The patient should urinate without pain, and the urine should become clear, with no traces of blood, bacteria, or nitrites. Furthermore, the treatment should prevent complications from occurring – the bacteria should not reach the kidneys as this will cause frequent infections, pyelonephritis, or sepsis (Flores-Mireles et al., 2015). The risk of renal scarring may be high if the infection remains untreated (Shaikh et al., 2016).
The drug treatment should start quickly, and the main medication for UTIs is antibiotics. The patient is 17, which means that she will need a pediatric dose. Trimethoprim can be used in this case, since it is often prescribed for UTIs. Its dosage for a UTI in children from 12 to 18 years is 100 mg orally every 12 hours for 10 days (“Trimethoprim,” 2018). The patient will have to take the antibiotic two times per day for 10 days to clear out the bacteria. It should be noted that the particular bacteria may be resistant to this drug, thus requiring a culture test.
The patient’s education should include personal hygiene and sexual activity guidelines as well as some nutritional advice. First of all, the patient should know a proper way of wiping (from front to back) after using the toilet. Second, the patient should be advised to avoid hygiene products that may irritate the urethra. These include sprays, crèmes, powders, and other products with deodorant features or additions.
Next, one should consult the patient about her sexual activity. The patient should urinate after intercourse and use condoms and safe lubrication (Flores-Mireles et al., 2015). These suggestions should prevent bacteria from spreading from one person to another and limit the patients’ exposure to possible infection causes.
Drinking fluids, especially water, are also helpful for preventing and treating UTIs. Hydration will help the patient to dilute her urine, cause frequent urination, and cleanse the system from bacteria (Flores-Mireles et al., 2015). Non-pharmacological treatments include the mentioned above hydration and symptom relief. Water may help the patient to increase urination. Some studies suggest that cranberry extract or juice may help with UTIs as well (Foxman, Cronenwett, Spino, Berger, & Morgan, 2015). The patient’s cautious behavior should help her to treat the infection effectively.
The patient’s symptoms and tests suggest that she has a UTI which can be caused by a variety of reasons. One should ask the patient about her sexual activity, previous bladder infections, and the use of a catheter. The treatment should eliminate bacteria and remove the cause of the infection while relieving symptoms. The prescription includes trimethoprim for 10 days 100 mg orally every 12 hours. Non-pharmacological treatments are hydration, cranberry juice, and proper hygiene. The education should focus on contraception, personal hygiene, and general awareness of infections.
Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13(5), 269-284.
Foxman, B., Cronenwett, A. E., Spino, C., Berger, M. B., & Morgan, D. M. (2015). Cranberry juice capsules and urinary tract infection after surgery: Results of a randomized trial. American Journal of Obstetrics and Gynecology, 213(2), 123-134.
Shaikh, N., Mattoo, T. K., Keren, R., Ivanova, A., Cui, G., Moxey-Mims, M.,… Hoberman, A. (2016). Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring. JAMA Pediatrics, 170(9), 848-854.
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