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"A REFLECTIVE ACCOUNT RELATING TO A 15 YEAR OLD FEMALE PATIENT PRESENTATION FOCUSSING ON PHYSICAL EXAMINATION AND MANAGEMENT OF A SELF-LIMITING CONDITION"
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Accurate and thorough assessment, from health history to performing a physical exam, can help uncover facts that help clinicians develop the right care plan (Rushforth, 2009). The patient’s appearance was examined. There were some signs of worry on her face but she did not seem to be in immediate pain. The nurse asked general questions about urination such as ‘how often do you go?’ or ‘do you wet yourself involuntarily?’ (Bickley & Szilagyi, 2012, p. 445). When the author questioned her about the details she replied that it only hurt while urinating. Pain while urinating can be from the kidney (loin pain), ureteric colic or coming from the bladder (Douglas et al. 2009). In children over 2 years of age dysuria and suprapubic, and abdominal pain are the most common presentation of a UTI (patient.co.uk).
Questioning her revealed that it was abdominal pain. A urinary complaint of this sort in children indicates dysuria, dysfunctional voiding, foul smelling urine, cloudy urine, enuresis or haematuria (Chiocca, 2010). Children with signs of and symptoms suggestive of UTI should have their urine tested (NICE, 2007). Initial management must include an accurate diagnosis of UTI from an appropriately obtained urine sample (Potts, 2012). The nurse explained to the patient that he will have to conduct an inspection and physical examination to diagnose the cause of urinary pain. Preparing for a physical examination includes a cosy and comfortable environment (Chiocca, 2010). Inspection consists of visual examination of the abdomen (Walker et al., 1990). The nurse explained that it is performed to look for skin abnormalities, abdominal masses and abdominal wall movement due to respiration (Walker et al., 1990). The child is undressed to examine the complete abdomen (Chiocca, 2010). Auscultation, percussion and palpation are the regular tests for abdominal assessment (Chiocca, 2010). The nurse explained to the patient that auscultation of abdomen is
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