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peds urinary

QuestionAnswer
when does the infant's urinary system function as adult's by 6 - 12 months old
what do premies decrease reabsorption of glucose, sodium, bicarb, phosphate
when is continence achieved 4 - 5 yo
can urinary function be regained after ARF yes
what does a u/a test for spec. gravity, ph, protein, glucose, keytones, WBCs, bacteria, casts
what does incresed WBCs mean infection or contamination during collection
what kind of test is u/a c&s
what to look for in CBC bun, creatinine, osmolarity
what are physical s/s of urinary defect cloudy, foul smelling urine, particles
what kind of radiologic tests done ct, vcug, dmsa, renal us, ivp, kub
what does vcug test for reflux of urine in bladder
what does dmsa test for blood flow, scarring
what does renal us test for position & size of kidneys, locates masses, stones & obstructions
what does ct test for tumors
what does ivp test for bladder emptying, masses
what does kub test for stones
are urodynamic test invasive yes
when should bladder control be expected 4 - 6 yo
what kind of milestone is bladder control developmental
what is enuresis repeated involuntary voiding
what is notcutia enuresis at night
what is diuria enuresis in the day
what is primary enuresis child has no dry nightsd/t a delay in maturation, small bladder
what is intermittent enuresis child has an occasional dry night d/t
what is secondary enuresis child is dry for 6 mo - 1 yr, then reverts back to bedwetting
what causes enuresis child is hard to rouse from sleep, not aware of bladder signal, unstable bladder contractions, DM or renal insufficiency, spinal bifida, constipation
what labs indicate enuresis u/a positive for e. coli d/t proximity to anus, ultrasound, vcug to view reflux
what is the Tx for enuresis fluid restriction, bladder training, enuresis alarm, meds
what meds can be given for enuresis imiparamine (tricyclic antidepressant), desmopressin (nose spray), oxybutynin chloride (anticholinergic for diuria)
what are some nursing Dx for enuresis situational low self esteem, impaired social interaction, compromised family coping, risk for impaired skin integrity
what are some causes of UTIs organisms (e. coli, staph, enterococcus), obstructions, voiding dysfunctions, anatomical differences, reflux, urinary retention, individual susceptibility, excessive masturbation, sexual abuse
what are s/s of UTI of the newborn unexplained fever, FTT, poor feeding, vomiting & diarhea, strong smelling urine, irritability
when should a child have a u/a any child less than 2 should have a ua with fever of unknown origin
what can UTI progress to polynephritis
what tests are done for UTI u/a for bacteria, c&s, dipstick leukocyte esterase for WBC, nitrate dipstick for bacteria
how is urine collected for a u/a clean catch, sterile cath or supra pubic aspiration
what radiologic studies are done for UTIs renal us & vcug, renal cortical scintigraphy
how are UTIs treated abx for 3-5 days
what kind of abx are given for UTIs sulfamides (Bactrim), nitrofurantoins (Macrodantin) & cephlosporins (rocephin)
what should you teach parents about UTI meds drink lots of water, teach how to administer store
what are s/s of children with pyelonephritis UTI s/s plus high fever & chills, back pain, CVA tenderness, n & v, looks sick
what are s/s of a child with a UTI abd pain, frequent, urgent & painful voiding, fever
how do you prevent a UTI wipe front to back & clean foreskin, don't hold urine, drink fluids to flush bladder, loose cotton underwear, no bubble baths, void b4 & after sex
how do you manage a UTI give all meds, take child to dr for follow up, call dr if s/s worsen
what is Tx for pyelonephritis for infants iv abx & hydration (in hospital), surgery to repair ureters
what is Tx for children with pyelonephritis im abx (outpatient), then po at home, surgery
how do you assess for a UTI vs, i&o, abd palpate & percussion, u/a, c&s, spec gravity
what is the most common type of nephrotic syndrome primary
what is primary nephrotic syndrome caused by caused by a disorder of the glomerulus
how can a child acquire secondary nephrotic syndrome secondary to a systemic disease (lupus, cancer, heavy metal poisoning)
what are s/s of nephrotic syndrome abrupt preorbital or lower extremity edema, wt. gain, HTN, anorexia, hemauria (coca-cola colored urine), decreased output, malaise, frothy urine, respiratory distress, abd pain, malnourished, pale & skinny, prominent veins, brittle hair
what labs confirm nephrotic syndrome *proteinurea of 50 mg/kg/day, serum albumin less than 20, increased BUN or creatinine
when does MCNS occur 2-6 y.o. boys
is BP normal or abnormal in child with MCNS normal
what are many children with MCNS misdiagnosed with allergies d/t periorbital edema & resp problems
what labs Dx MCNS 3-4+ proteinuria, dark & frothy urine, microscopic hematuria, elevated serum cholesterol, triglycerides & h/h, decresed serum albumin
what is done for a child not responding to Tx for MCNS biopsy
what is Tx for nephrotic syndrome 5-7 days of prednisone, iv fluids with albumin, alkylating agents (Cytoxin or Leukeran), oral diuretics, ACE inhibitor, broad spectrum Abx, no live immunizations for 6 mos, normal diet but no added salt if on corticosteroids
what are causes of poly cystic kidney disease genetic disorder, liver abnormalities, dilation of collecting ducts, enlarged kidneys of newborns
what are s/s of pckd r sided HTN, hematuria, frequent urination, poor growth, UTIs, proteinuria, polyurea & polydypsia, uremia
what tests detect pckd renal us, renal biopsy, liver funct. test (normal at first, then abnormal)
what is Tx for pckd teach diet & med, enteral nutrition, peritoneal dyalisis, transfusion
what is acute glomerulonephritis inflammation of the glomeruli
what is acute glomerulonephritis caused by group a beta strep, pneumococcus & coxsackie virus
what age group is more susceptible to acute glomerulonephritis 5-8 y.o.
what are s/s of acute glmerulonephritis lethargy (1st sign), microscopic hematuria, tea colored urine, mild periorbital edma, HTN, feverish, abd pain, headache, CVA tenderness
what tests Dx acute glomerulonephritis BUN & creatinine, elevated K & bicarb, ESR, serum lipids increased & ASO titer, anti DNAse B titer, decreased serum C3, u/a
what to look for in u/a to Dx acute glomerulonephritis decreased Ph, hematuria, proteinuria, tea colored, WBC
what is Tx for acute glomerulonephritis Tx s/s for HTN- antiHTNs (Apresoline), diuretics (Lasix) & diet -fluid & sodium restrictions
what are some congenital abnormalities of the GU tract hypospadius/epispadius & cryptochordism
how is hypospadius/epispadius Dx prenatal US or examination at birth
what is Tx for hypospadius/epispadius surgical repair, pain mngmnt (muscle relaxants for bladder spasms), restrict play & strict I&O
what meds are used to Tx hypo/epispadius pain- tylenol, Abx- til stent falls out, anticholinergis- ditropan, levbid
what is cryptochodism undescended testicle
what does cryptochodism result in testosterone deficiency
what should be done for a child with ESRD renal transplant
what needs to be done before a renal transplant dialysis
where do donors for renal transplant come from relatives or cadavers
what is a requirement for renal transplant must be ABO compatible
which has a higher rate of survival, a donor from a relative or cadaver relative
wht improves the survival of a graft human leukocyte antigen
when should children waiting for a renal transplant get dialysis severe FVO, CHF secondary to FVO, pulmonary edema, severe HTN, metabilic acidosis or hyperkalemia not ersponsive to meds & BUN more than 120
Whats the most common complication of renal transplants rejection
what msut patient do if they reject the new kidney take antirejection drugs for the rest of their life
what antirejection drugs can be given Neoral, azathioprine, prograg, mycophenolate mofetil, prednisone
what are some complications of renal transplants opportunistic infections, lymphomas, skin cancer, HTN, non-compliance (teenagers, unstable family, low self esteem)
how to you manage care of a renal transplant pt. teach pre & post op procedures (TCDB, IS), meds, follow up appts., health promotion(stay out of bad weather, crowds), s/s acute rejection & infection, how to contact MD
Created by: jclrn2010