Reference no: EM133663822

Assignment:

A 26-year-old female presents at the clinic with symptoms of dysuria, frequency, and urgency. Further history yields 2 days of these symptoms but no fever, chills, or flank pain. She describes a burning discomfort during and immediately following urination and feeling the need to void every half hour. There is no vaginal discharge, itching, or odor. She uses a diaphragm and spermicide for birth control. She requests "a urine culture and some sulfa pills." When asked to explain, she says that she has had many "bladder infections" over the past 3 years and "sulfa pills usually work." She was evaluated approximately 5 years ago with an IV pyelography and cystogram, and "nothing was wrong."

Assessment

A midstream urine specimen is collected for urinalysis and culture. A urine dipstick reveals 21WBCs (pyuria) , 11 RBCs ( hematuria,) and + nitrates. Her pregnancy test is negative. She exhibits no costovertebral angle or abdominal tenderness. Her vital signs are within normal limits.
Janice looks essentially well. She is afebrile. 

1. What would be the initial management plan for an adult woman with a simple uncomplicatedurinary tract infection (UTI)? What is a common pathogen for UTI in young women?
2. What education is needed when treating a patient with a UTI?
3. Janice returns to the office and states she is " not getting better". What would you assess for and what treatment plan is next?