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Diagnosis with 3 differentials would be? 

 

Miriam presents with her mother reporting that she has started having urinary accidents at school this past week. Mom notices she is scratching at her private area. She also had some diarrhea the last few days. This morning Miriam woke up with a fever of 100.6 and emesis.

PE: 100.2, HR 98, RR 20, BP 98/42, Wt. 38lbs
Lungs: CTA
Heart: RRR with no murmur
Abdomen: Soft, tenderness noted in suprapubic area, BS hyperactive, no CVA tenderness
GU: Erythema urethra, scratch marks noted, no vaginal drainage, no tearing of vaginal area.
Skin: erythema to vaginal area, no other rash, skin moist and warm.

 

U/A: Specific Gravity: 1.015
pH: 6.5
Leukocytes: Moderate
Blood: Negative
Nitrite: Positive
Ketones: Trace
Bilirubin: Negative
Urobilinogen: Normal
Protein: Negative
Glucose: Negative

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HEALTH SCIENCE
NURSING

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