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Pediatrics
Genitourinary-GU
| Question | Answer |
|---|---|
| ____ is a protrusion of the bowel into the groin region that causes an observable and palpable bulge in that area? | Inguinal Hernia |
| A Inguinal Hernia is both ___ and ___ bulge in the groin region? | observable and palpable bulge in the groin region |
| Approximately ___ of all hernias are Inguinal Hernias? | 80% |
| T/F Inguinal Hernias are more common in females? | False They are more common in males (90%) |
| In Inguinal Hernias the blood flow is ___ to the small intestine? | blood flow is impeded to small intestine |
| For Inguinal Hernia a therapeutic managment is prompt elective surgery to avoid _____? | Incarceration-blood flow impeded to small intestine |
| Prompt elective surgery is needed in Inguinal Hernia if there is a _____, _____, or____? | Intestinal Obstruction; Strangulation; or gangrene |
| T/F inguinal Hernia there is no bilateral involvement and surgery is usually inpatient? | False Inguinal Hernia there IS bilateral involvement and surgery is usually OUTPATIENT |
| In pre-op care of a inguinal hearnia what do you want to observe for? | redness; swelling; inability to reduce the hernia |
| What do you want to monitor in an infant pre-operatively for inguinal hernia? | crying or straining-causes compression |
| What do you want to monitor in an older child pre-operatively for inguinal hernia? | Straining, coughing, standing for a long time |
| Post op inguinal hernia how do you prevent infection? | sponge bath for 2-5 days and frequent diaper changes-infants |
| How do you promote comfort in a post op inguinal hernai pt? | Acetaminophen |
| What are post op activity restrictions for infants and toddlers following a inguinal hernia repair? | no physical restrictions |
| What are post op activity restrictions for older children following a inguinal hernia repair? | restrict heavy lifting, pushing, wrestling,fighting, bicycle riding and athletics for 3 WEEKS |
| What are post op activity restrictions for School Children following a inguinal hernia repair? | Attend cllass as soon as comfortable but NO PE for 3 weeks |
| What is a Hydrocele? | A fluctuant mass of fluid within the processus vaginalis that presents as scrotal swelling |
| In a ______ Hydrocele peritoneal fluid is trapped in the testicular tunica vaginalis during _____ of the processus vaginalis? | In a NONCOMMUNICATING Hydrocele peritoneal fluid is trapped in the testicular tunica vaginalis during CLOSURE of the processus vaginalis |
| In Noncommunicating hydrocele fluid is _____ and usually there is ____ treatment necessary? | In Noncommunicating hydrocele fluid is gradually reabsorbed and usually there is NO treatment necessary |
| In a ____ Hydrocele processus vaginalis remains OPEN? | Communicating hydrocele |
| What are the changes in a communicating hydrocele in the intra-abdominal pressure and gravity? | force peritoneal fluid into processus vaginalis and scrotal swelling of variable size |
| In a communicating hydrocele what does transillumination show? | transillumination shows fluid |
| a communicating hydrocele predisposes a child to ____? | herina |
| Surgical repair is necessary for a hydrocele if what is present? | 1. Lg, symptomatic commnicating Hydrocele 2. Remains after 3 months of age or 3. Hernia |
| Surgical repair of a hydrocele is best done by ___ year of age and is usually ___ surgery? | surgical repair is best done by 1 year of age (sooner if hernia present) and is usually outpatient surgery |
| What discharge teaching do you want to give following a surgical repair of a hydrocele? | Temporary swellilng and discoloration of the scrotum is normal and resolves spontaneously. Also teach them same as the care after inguinal hernia |
| ___ is failure of one or both testes to descend into the scrotal sac? | cryptorchidism |
| What is the incidence of cryptorchidism in a premature infant and term infant? | Incidence in a premature infant is 30% and term 3-4% |
| Testes normally descend during the ___ month of gestation? | 8th month of gestation |
| What are retractile testes? | Normally descended testes |
| Retractile testes are usually ___ and can be "___" or pushed back into ____? | Retractile testes are usually BILATERAL and can be "milked" or pushed back into SCROTUM |
| In a ____ testes they are hyperactive cremasteric reflex pulls testes back into inguinal canal; the skin over front & inside of thigh sensitive to stimulation and sensitive to touch & cold? | Retractile Testes |
| What is the medical management for cryptorchidism? Examples and why do we use it? | Hormone therapy may cause testicular descent; luteinizing hormone-releasing hormone (nasal spray); Human chorionic gonadotropin (injection) |
| What is orchiopexy? When is it don by? | Surgical placement of testes in scrotum; should be done if testes have not descended by 1 year of age and it is usually outpatient |
| Surgical management of cryptorchidism is before ___ and ___ of age and ___ if hernia is also present? | orchiopexy is the surgical management of it and is Best time psychologically between 1-2 years of age (before child is aware of anything) and EARLIER if hernia is also present. |
| What are the physical risk if orchiopexy is not done early? | If surgical repair of cryptorchidism is not doone early there is a risk of reduced fertility and testicular malignancy |
| Why is there reduced fertility if orchiopexy is not done early? | Higher degree of body heat in abdomen damages testes |
| If surgery is not done for cryptorchidism what are the risk for testicular malignancy: there is a increased risk of __-__%, it usually occurs __ to __ decade; and the greatest risk if untreated or surgery is done during or after ____? | Increased 20-40%; usually occurs in 3rd-4th decade; Greatest risk if untreated or surgery is done during or after puberty |
| What are the post op care for orchiopexy? | 1. Prevent infection-keep operative site free of stool & urine 2. Promote comfort-pain meds prn 3. Teach self examination of testes to older children 4. Teach importance of LONG term follow-up care--for tumors and fertility |
| What is Hypospadias? | Congenital anomaly in which the urethral opening is located along the ventral surface (underside) of hte penile shaft |
| T/F Chordee typically goes with hypospadias? | True |
| Chordee causes ___ of the penis? | constriction of the penis |
| ___ is ventral curvature of the penis and the replacement of normal skin with fibrous band of tissue? | Chordee |
| Hypospadious occurs __ in every ___ Male children; Increased risk if ___ or ___ have hypospadias? | 1 in every 500 male children and increased risk if father or sibling have hypospadias |
| The child with hypospadias should not be circumcised because why? | The child with hypospadias should not be circumcised because foreskin may be used in surgical reconstruction |
| What is the Optimal time for surgical management of hypospadius and does it require more than 1 surgery? | Optimal time-before 18 months of age; single or multistage surgery-depends on severity & where the opening is located |
| What are the potential areas of surgical repair in a hypospadius pt? | Correction of chordee; straightening of penis; construction of new urethra |
| What does urinary diversion allow in a surgical repair in a hypospadius pt? | allows healing of urethra and prevents infection of site |
| What are the goals of surgical management of hypospadious pt? | 1. to make urinary and sexual function as noraml as possible 2. to improve cosmetic appearance of genitalia |
| Post op surgical repair of a hypospadious pt how do you care for the drainage system? | 1. prevent disruption (restraints)-until area is healed (1st couple of days) 2. Tape to prevent tension 3. No clamping or kinking of tube 3. maintain patency |
| What are the nursing interventions following a hypospadious surgcial repair? | 1. Care for the drainage system 2. Reduce risk of infectioon 3. compression dressing to penis 4. control bladder spasms 5. restrict activity in older children while healing |
| In hypospadious pts following surgical repair you as a nurse want to give ____ oral antibiotics; urine acidfying agent (eg, ___ acid; and ____-urethral meatus-to prevent superficial infections. | In hypospadious pts following surgical repair you as a nurse want to give prophylactic oral antibiotics; urine acidfying agent (eg, ascorbic acid( and antibiotic ointment-urethral meatus-to prevent superficial infections. |
| Why do you want to apply compression dressing to penis following a surgical repair of a hypospadious pt? | reduce edema and reduce ecchymosis |
| How do we control bladder spasms following a surgical repair of hypospadious pt? | Ditropan and Belladonna-opium suppositiories they both reduce pain in the area while it is healing |
| Discharge planning of a surgical repair hypospadious pt include care of ___ drainage system (possibly for several months); encourage ____; Avoid the following activities: ___ play; swimming; ___ sports; ___ toys; and SANDBOXES. | discarge planning: care of urinary drainage system may have to keep for several months; encourage fluids; avoid rough play; swimming; contact sports; straddle-type toys and sandboxes |
| ____ is a congenital anomaly in which the urethra is located on the dorsal surface (topside) of the penile shaft? | Epispadias usually occurs with other congenital problems and occurs in 10% of kids |
| What is mild epispadias? Severe? Surgical Intervention? | Mild-meatus located in front of the glans penis Severe-extends to exstrophy of the bladder and surgical intervention depends on degree of involvement |
| T/F Exstrophy of the bladder never occurs with epispadias? | False Exstrophy of the bladder may occur with epispadias |
| Exstrophy of the bladder is a ___ anomaly characterized by the ___ of the urinary bladder to the ____ of the body through a defect in the ____? | a congenital anomaly characterized by the extrusion of the urinary bladder to the outside of the body through a defect in th elower abdominal wall |
| exstrophy of the bladder incidence __ in 100,000 and higher in ____? | 3 in 100,000 and incidence is higher in Males |
| T/F the surgical management of exstrophy of the bladder is done in a series of staged reconstructions? | true |
| What is the initail surgical management of exstrophy of the bladder? | initial-closure of abdominal defects within first few days of life |
| After the initial surgical management of exstrophy of the bladder what are the subsequent surgeries done? | epispadias repair; bladder enck reconstruction; creation of urethral sphincter mechanism; genitalia reconstruction |
| T/F In Exstorphy of the bladder urinary diversion may be permanent depending on success of surgery? | True |
| In a exstorphy of the bladder baby you wnat to promote parent-infant bonding how? | Assist parent-bathe, feed, diaper; support parents-grieve loss of "perfect child" |
| Pre-operative nursing care for exstorphy of the bladder prevent ____-PREVENT INFECTION-cover defect w/ ____(protect exposed ___ tissue & clear plastic wrap or thin film dressing w/out adhesive (NO ____)) Keep surrounding area ___ & protect from ___? | PREVENT INFECTION-cover defect w/ sterile nanadhearing dressing (protect exposed bladder tissue and clear plastic wrap or thin film dressing w/out adhesive (nO petroleum jelly)) Keep surrounding area clean & protect from dribbling urine |
| Routine postsurgical care; wound care; monitor urine output and appearance; and comfort measures are all post op nursing care for? | Exstorphy of the bladder |
| What is Nephrotic syndrome? | Nephrotic syndrome is a clinical state characterized by abnormal increases in the permeability of the glomerulus to plasma protein |
| In ____ there is an intrinsic problem with kidney and not systemic? | Nephrotic syndrome |
| Nephrotic syndrome is a disorder of ___ of the kidney? | glomerulus |
| Minimal change nephrotic syndrome is the ___ type in children (80%) and is ___? | Minimal change nephrotic syndrome is the most common type in children (80%) and is idiopathic |
| In the primary group of nephrotic syndrome the other histologic patterns are: focal ____; Membranoproliferative ____; and Membranous ____? | Other histologic patterns: Focal glomerulosclerosis; membranoproliferative glomerulonephritis; Membranous glomerulonephropathy |
| What are the secondary causes of nephrotic syndrome? | glomerular damage r/t systemic disease (lupus, Diabetes, heb B/C); Drugs; Toxins |
| Congenital Nephrotic syndrome is ____ autosomal recessive; Mangement is ___ and death is common ___ of age? | Rare autosomal recessive; management-dialysis, transplantation; Death is common first two years of age. Usually goes along with other disease too. |
| Glomerular membrane is normally impermeable to ____? | large proteins |
| In Nephrotic syndrome the glomerular membrane is permeable to ___, especially ____? | is permeable to proteins especially albumin |
| In Nephrotic syndrome the glomerular membrane changes and alows for albumin loss in the urine leading to ____ and results in serum albumin decrase leading to ______and there is fluid shifts from plasma to interstitial spaces leading to ___ &___? | increased Albumin loss in urine (hyperalbumiuria); decreased serum albumin (hypoalbuminemia); fluid shifts from plama to iterstitial spaces leading to 1. hypovolemia-decread blood volume & 2. Ascities-edema |
| In nephrotic syndrome what is the primary manifestation? | Massive PROTEINURIA |
| What are the manifestations of nephrotic syndrome? | Hypoalbuminemia; edema; hyperlipidema; Weight gain; diarrhea, anorexia; respiratory difficulties; skin breakdown/pallor; malnutrition; lethargy, irritability, depression; dark,frothy urine |
| Hypoalbuminemia; edema; hyperlipidema; Weight gain; diarrhea, anorexia; respiratory difficulties; skin breakdown/pallor; malnutrition; lethargy, irritability, depression; dark,frothy urine are all manifestations of ___? | nephrotic syndrome |
| What areas could have edema in nephrotic syndrome? | periorbital; ascites (stomach); Labial/scrotal; lower extermities. There is weight gain from the edema usually |
| In nephrotic syndrome there is commonly a recent history of ___ and Cellulitis; pneumonia; peritonitis and ____ are other common manifestations. | Recent history of URI is common; other common manifestations are cellulitis; pneumonia; peritonitis; and sepsis |
| Edema; steroids; ___ therapy; loss of ___ and poor ____ are some causes of infection in nephrotic syndrome? | Edema; steroids; immunosppressive therapy; loss of immunoglobulins and poor nutrition are some causes of infection in nephrotic syndrome |
| What are the urinary manifestations of nephrotic syndrome? Hint Urine volume ___; urine concentration ___; Massive ____; ____ hematuria; specific gravity ____ | Urine volume decreased; urine concentration increased; Massive proteinuria; Microscopic hematuria; specific gravity increased are all urinary mainfestations of nephrotic syndrome |
| In treating Neprotic syndrome you want to decrease urinary ___ loss; ___ nutrition; restore normal ___ function; and prevent or treat any ____? | Decrease urinary protein loss; balance nutrition; restore normal metabolic function; prevent or treat any infection |
| Edema causes ___ breakdown and ___ mobility? | edema causes skin breakdown and decreased mobility |
| Nursing care of Nephrotic syndrome includes: medications; monitoring ____; nutrition/fluid managment; Skin care; prevention of ___; activity; respiratory care; and socialization/emotional support? | Medications; Monitoring I&O swelling, wt...; nutrition/fluid managment; skin care; prevention of infection; activity; respiratory care; socialization/emotional support |
| What is the primary therapeutic agent used in nephrotic syndrome? | Prednisone |
| What are the goals of prednisone in nephrotic syndrome? | reduce excretion of urinary protein and promote excretion of edema fluid |
| Prednisone used in Nephrotic syndrome: Diuresis usually occurs between day __-__? Continue until urine free of protein and remains so ___days to __ weeks; Taper dosage __-___? | Diuresis-usually between day 7 & 21; Continue until urine free of protein and remains so 10 days to 2 weeks; taper dosage weeks to months |
| What are the side effects of prednisone? The reason you want to taper dose as soon as you can.HINT ___ face; ___ hump; Hirsutism; ___ appetite; gastric ___/bleeding; HTN; susceptible to ____; Growth ___ | Moon face; Buffalo hump; Hirsutism; increased appetite; gastric ulcer/bleeding; HTN; susceptible to infection; Growth retardation |
| What is Hirsutism? It is a side effect of ___? | development of dark black hair (shoulders, middle of back); a side effect of prednisone |
| Relapse of Nephrotic syndrome is seen in ___ % of children with ___ and tendency of relapse ___ with time? | Seein in 85% of children with MCNS (minor change nephrotic syndrome) and tendency of relapse decreases with time |
| The criteria of relpase of nephrotic syndrome: teach parent to monitor ___; Proteinuria __ consecutive days, __ or more; Increased edema, weight gain and ___? | Teach parent to monitor urine dipstick; proteinuria 3 consecutive days, 2+ or more; Increased edema, weight gain, and fever |
| In fluid management of nephrotic syndrome monitor ___; report less than ____ (glomeular changes); Monitor edema by ___; and measure ___? | Monitor I & O; report less than 1 ml/kg/hr (glomerular changes); Monitor edema; weigh daily-same time, same scale; Measure abdominal girth |
| In Nephrotic Syndrome you want to monitor Blood pressure how often? BP usually is ___? What are the factors that can promote HTN? | Monitor at least 1x per shift; BP usually normal to slightly decreased; Factors that can promote HTN are increased total body fluid volume and concurrent steroid therapy |
| What is the diet of a nephrotic syndrome pt during relapse and steroid therapy? | No added salt diet; Avoid High sodium foods; with SEVERE Edema further sodium restricions |
| What is the diet during remission in a nephrotic syndrome pt? | Regular diet |
| How can we prevent skin breakdown in nephrotic syndrome? | Change position q 1-2 hrs; Keep skin clean and dry; support edematous body parts |
| How can we prevent infection in nephrotic syndrome? | Meticulous handwashing; avoid infectious persons; antibiotics during edematous phase; immunizations; report illness |
| What do we want to monitor and report in nephrotic syndrome? | Fever; cough; sore throat; and abdominal pain |
| What is the activiy of nephrotic syndrome in the edmatous phase and durring remission? | Edematous phase- BED Rest REmission-No restrictions |
| What does prognosis depend upon in nephrotic syndrome? | response to steroid therapy and histology of the renal lesion |
| T/F there is Very good prognosis with most nephrotic syndrome pts | True |
| T/F Histologic pattern other than MCNS-there is a decreased change of progressive renal failure in nephrotic syndrome? | False Histologic pattern other than MCNS-GREATER change of progressive renal failure |
| What is acute glomerulonephritis? | Acute glomerulonephritis is an inflammation of the glomeruli |
| Acute gomerulonephritis most commonly follows a ___ infection of the throat or skin? | Group A beta hemolytic streptococcal infection- AKA strep throat |
| What is the major difference between other nephrotic syndromes in acute glomerulonephritis? | GROSS HEMATURIA |
| What are the clinical manifestations of acute glomerulonephritis? | Variable; Gross hematuria; HTN; Edema-periorbital; Anorexia; Weight gain; Decreased urine output |
| What are the 3 complications of acute glomerulonephritis? Hint 1. Hypertensive ____ 2. Acute cardiac ___ 3. Acute ____failure | 1. Hypertensive encephalopathy 2. Acute cardiac decompensation 3. Acute renal failure |
| What are the manifestations of hypertensive encephalopathy? | HA, Vomiting, blurred vision, dizziness, resltessness, lethargy, disorientation, tachycardia, and convulsions |
| The Acute edematous phase of acute glomerulonephritis usually last __ to__ days and what are the manifestations? | usually lasts 4-10 days; Manifestations: Listless, Apathetic; Anorexic; Increased BP; Urine-cloudy, smoky brown; Urine output decreased |
| What are the first signs of improvement in acute glomerulonephritis? | Small increase in urine output and decrease in body weight-edema is absorbed & body excretes |
| When does the diuretic phase of acute glomerulonephritis occur? | Usually occurs 1-2 days after the signs of improvement; Copious diuresis |
| acute glomerulonephritis has a gradual resolution. The blood pressure will decrease in ___ weeks; Gross hematuria disapears in ___ weeks; and Microscopic hematuria may ___ for ___ months? | Blood pressure decreased in 2-3 weeks; Gross hematuria disappears in 1-3 weeks; and Microscopic hematuria may persist several months |
| What are the Nursing Interventions/care of acute glomrulonephritis? | Fluid balance monitoring; monitor for complications; prevent infection; medications; diet; activiy-less restrictions in diuretic phase |
| What are the medication classifications given for acute glomrulonephritis? | Diuretics; Antihypertensives; and Antibiotics |
| Poor appetite affects ___? | intake |
| What is the diet of a uncomplicated child with acute glomrulonephritis? | regular diet with NO added salt |
| What is the diet of a hypertension or edema pt with acute glomurlonephritis? | Moderate sodium restriction |
| What is the diet of a oliguria pt with acute glomrulonephritis pt? | Restict POTASSIUM --should be excreated by the kidneys |
| A pt with Severe azotemia with acute glomrulonephritis should restrict ___ in their diet? | restrict protein |
| The prognosis of acute glomrulonephritis: APSGN (strep)-usually runs course in about ___; Recurrence-unusual after first ___ months, caused by ___ or unless get strep bacteria again; Most recover ____; and Deaths are ____? | APSGN (strep) usually runs course in about 1 month; recurrence unusual after fist 3 months, caused by bacteria or unless get strep bacteria again; Most recover completely and deaths are rare. |
| UTI-Urinary tract infection referes to an infection within the urinary tract affecting the ___,___,___ or ___ system of the kidneys? | UTI refers to an infection within the urinary tract affecting the bladder, urethra, ureters or collecting system of the kidneys |
| A UTI infection of the lower tract includes? | Urethritis; Cystitis; and Prostatitis |
| A UTI infection of the Upper tract include? | Pyelonephritis;Vesicoureteral Reflux (VUR)-urine is reflexed up the ureters by the bladder |
| What are the risk factors for UTI? Hint Age/Gender | Neonate/young infant-boys-not clleaned off good; Older infant to young adult-More common in females peak 2-6 years if no anomaly-potty training; Postmenopausal women due to hormone changes; and Elderly |
| E. Coli; Klebsiella pneumoniae and proteus miabilis are all Gram ___ that are common pathogens of UTIs? | Gram Negative Bacilli |
| What is the most common Gram Negative Bacilli that cause UTI? | E. Coli (80%) |
| What is the gram positive cocci that can cause UTI? | Staphylococcus saprophyticus - it is uncommon |
| In treating a UTI you need a urine culture to find right ___ & right ___? | right bacteria and right medications to treat |
| Hematogenous spread of UTI usually occurs below ___ months of age or if Older-must have prior injury to urinary tract. Give 3 examples for older | Usually occurs below 4 months of age; Older-must have prior injury to urinary tract: 1. obstruction of ureter 2. Damage from stones 3. Renal scars |
| What is Nephrolithiasis? | Kidney stones |
| How is an ascending organism usually introduced in a UTI in those over ___ months of age? | organisms usuallyintroduced via ureters, bladder and then up into the kidneys in those over 4 months of age |
| Anatomic or neurologic obstruction (abnormalities can be hereditary; Nephrolithiasis; Vasicoureteral reflux (VUR); Nontractable foreskin; and Labial fusion are all potential anatomic abnormalities of _____? | UTI |
| T/F Symptoms of UTI vary according to age and site? | True |
| What are the S/S of a Lower UTI? | frequent urination (>q 2hrs); Suprapubic discomfort or pressure; Urgency; Dysuria; may have hematuria |
| What are the S/S of a Upper UTI? | Chills; Fever; Flank pain (up in the kidneys) |
| In Neonates and Infants what are the s/s of UTI? | Vague, nonspecific symptoms; FTT; Difficulty feeding; irritability; Diarrhea; Persistant diaper rash |
| In a Neonate and infants a fever without focus of infection (can't find another cause for infection) suggest ___? | UTI-need urinary tract evaluation as part of sepsis work-up |
| Urinalysis; Urine dipstick; Urine pH are all screenings for ___? | UTI |
| UTI: A Positive urine dipstick will show what? | Positive leukocyte esterase and positive nitrite |
| What will the urine pH of a UTI be? | alkaline (more than 7) more acidic urine is the less likely bacteria can grow |
| _____ _____ is the GOLD STANDARD OF DIAGNOSIS for UTI? | Urine Culture |
| What are the 3 methods of urine collection? | 1. Catherterization or suprapubic aspiration (needle goes straight to bladder through abdomen)-more accurate for culture 2. Clean-catch 3. U-bag for collection from infant--not accurate for culture |
| What are the objectives of treatment of a UTI? | 1. eliminate the current infection 2. identify contributing factors to reduce the risk of recurrence (let them go to the BR when needed) 3. prevent systemic spread of infection 4. Preserve renal function |
| A Complicated UTI in a child you want to give __ or ____antibiotics followed by ___? | Give IV or IM antibiotics followed by oral antibiotics |
| Why do you want to give Pyridium to a child with UTI? | to relieve pain and pyridium also releieves bladder spasms |
| A Uncomplicated UTI in a child you want to give Trimethoprim-sulfamethoxazole; (TMP-SMX, Septra, Bactrim), nitrofurantion, or amoxicillin to treat a Gram ____ infection | Uncomplicated UTI---Gram Negative infection |
| After medications are completed in a UTI pt do a monthly culture for ___ months (especially w/ frequent UTIs) then every ___ months for ___ months? | Follow-up after Medicaitons: Monthly culture for 3 months (especially w/ frequent UTIs); Then every 3 months for 6 months |
| A 4 yr old gril is seen in the outpt center w/ a UTI. She is started on Bactim. Identify teaching interventions that would be important when discussing nursing care w/ the child's mother. | Take ALL of the antibiotic don't stop; let her go to the bathroom when she has to; wipe front to back |
| General Measures for UTI: Report Infection ___; Teach proper ____; Avoid ___ irritants; Decrease irritation from ____; Frequent ____; Sexually active-void after ___; ___ constipation; Encourage adequate ____; Acidify ___ and drink ___ juice? | Report infection early; Teach proper hygiene; Avoid chemical irritants; decrease irritation from clothing; frequent voiding; sex active-void after intercourse; avoid constipation; encourage adequate fluids; acidify urine; & drink cranberry/blueberry juice |
| What are some chemical irritants you want to avoid in UTIs? | soap,dye, perfume, bubble baths (bubble baths can cause UTIs) |
| ___% of UTIs occur from being sexually active? | 70% |
| What would be considered adequate fluids in a child? Adult? | Child - 100 ml/kg Adult 2-3 L/dayNon caffeine & non carbinated beverages |
| How do you acidify urine? | Vitamin C-bacteria can't live in acidic environment; Urine pH 5 -- leads to decreased bacterail multiplicaiton |
| At what age can you use cranberry/blueberry juice for UTI prevention? | AFTER AGE 1 |
| Use of cranberry/blueberry juice prevents adherence of ___ to bladder wall; __ to ___ glasses of juice/day for __ to __ to work as prevention strategy? | Prevent adherence of bacteria bladder wall; 2-3 glasses of jucie/day; 4-6 weeks to work as prevention strategy |
| What is Enuresis? | Bed wetting |
| Incidence of Enuresis is higher in ___; Not a problem before ___ yrs of age; Five year olds ___ incidence; 10 year olds ___ incidence? | Primary Enuresis incidence is higher in boys; not a problem before 6 yrs (before this developmental age can't control); Five year olds 7-15% incidence and 10 year olds 2-3% incidence |
| Enuresis Alarm; Motivational ___; Bladder ___ exercises and drug therapy are all managements of Enuresis? | Enuresis Alarm; Motivation Therapy; Bladder Stretching Exercises and drug therapy are all management of enuresis. |
| Why would a enuresis alarm clock help? | Can go off at certain time limits to get up to bathroom to avoid weting the bed |
| Motivation Thearpy use Star carts and Dont use ___? | star carts; dont use food:not having wet bed & getting up to alarm positive reinforcement |
| Name 3 drugs used for management of enuresis. | 1. Imipramine 2. DDAVP 3. Ditropan (most common) |
| To help with enuresis limit fluids to an ___ appropriate level? | age appropriate level |
| What do you want to discourage in a family with enuresis child? | Discourage punitive approach-limit response to accidents and teach child to participate in positive behaviors like getting up to alarm clock |
| In Enuresis pts observe for ___ of medications and get ___ if needed? | In enuresis pts observe for side effects of medications and get counseling if needed. |
| A common side effect in kids with parents going through divorce is ___ so get them ___? | side effect of divorce is enuresis so get them counseling |
Created by:
cgwayland
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