Nurse Ashley is caring for a 6-year-old female patient in an outpatient doctor's office

Patient Results

Leukocytes:

Nitrates

Urobil

Protein

PH 6.5

Blood

Spec Gravity 1.020

Ketones

Bilirubin

Glucose

Based on the patient's presentation, what would the nurse anticipate her diagnosis to be?

Phimosis is a condition in which the foreskin of the penis is tight or difficult to retract over the glans (head of the penis). It is normal for infants and young boys to have a non-retractable foreskin, and it usually resolves naturally as they grow. Pulling back the foreskin forcefully or attempting to clean under it in an infant can cause injury, pain, and even infection.

The correct approach is to gently clean the external genitalia with mild soap and water, but the foreskin should not be forcibly retracted in an infant. The foreskin will gradually become more retractable on its own as the child grows.

The other statements are generally appropriate:

A. "This is a normal finding as my son is uncircumcised": Phimosis is more common in uncircumcised males, and it is often a normal developmental variation in infants.

B. "This means that there is a narrowing of his torch that could lead to an infection": This statement recognizes the possibility of complications related to phimosis, such as the risk of infection, which is accurate.

D. "If this continues to be an issue, we may have him circumcised": Circumcision may be considered in cases where phimosis persists and causes problems, but it is usually not recommended during infancy unless medically necessary. This statement acknowledges a potential treatment option.

Kawasaki disease is a rare but serious condition that primarily affects children, particularly those under the age of 5. It is characterized by inflammation of the blood vessels throughout the body, including the coronary arteries. If left untreated, Kawasaki disease can lead to the development of aneurysms in the coronary arteries. These aneurysms can put the child at risk for complications such as thrombosis (clot formation) or rupture of the affected arteries, which can be life-threatening.

The other options (A, C, and D) are not typically associated with Kawasaki disease:

A. Sepsis: Kawasaki disease is not an infectious disease, and it does not directly lead to sepsis. It is an inflammatory condition believed to have an autoimmune component.

C. Meningitis: Kawasaki disease primarily affects blood vessels and does not lead to the development of meningitis.

D. Mitral valve disease: While Kawasaki disease can affect the cardiovascular system, it is not a direct cause of mitral valve disease. The development of mitral valve disease would be a separate cardiac issue unrelated to Kawasaki disease.