Reference no: EM133657667

A 25-year-old female presented to the clinic for " urinary frequency" x 5 days. The patient reports flank pain, dysuria, abdominal discomfort, fever, and nausea with three vomiting episodes in the last 24 hours. She has not been able to eat or drink fluids without having a vomiting episode. The patient diaphoresis, hematuria, unprotected sexual encounter with a new partner, or vaginal discharge. She has been married for ten years, lives with her husband and has two children. She had a hysterectomy about a year ago. She has no significant medical history, and she was adopted and does not know about her biological family.

Physical Examination:

Vital Signs: Temp- 101.2, Resp: 23, 02 sats-99% on RA, BP- 99/55. She does not appear to be in any acute respiratory distress. On examination, she has mild to moderate tenderness on palpation of the right flank and suprapubic tenderness. The Bowel sounds are NAx4. All other physical examinations were unremarkable.

CBC- WBC- 13, Hgb- 14, Neutrophil count-10,000, UA is positive for Leukocytes and Nitrites. Urine culture is pending.

Discuss the following:

What are the pertinent clinical findings that are concerning to the nurse practitioner. Discuss the medical history, subjective history, and physical findings are pertinent to note.
Discuss the top three differentials and your presumptive diagnosis.
What diagnostic labs or imaging would you utilize to include or exclude your differentials.
What is the management plan for this patient? Discuss medication (Include the dosage, duration, and timing for medication).
Discuss any referrals that were done for this patient, if indicated?
Discuss the evidence-based practice clinical guidelines that were utilized for this patient?