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ped/urinary
...
| Question | Answer |
|---|---|
| what are functions of kidneys? | maintain homeostasis, stimulate rbc formation in the bone marrow, produce renin to reg bp, nephrons are functional unit, regulate volumeand composition of body fluids, excretion of waste materials. |
| what are the components of the kidneys? | kidneys, ureters, bladder, urethra |
| Important aspects of childs urinary system? | fluid is larger fraction of body weight, glomerular filtration and absorption is lower until 1-2 yrs of age, more susceptible to trauma, function is immature until 2 yrs old |
| Each gender has gonads and accessory organs. what are gonads? | Gonads produce sex cells and hormones that affect reproductive organs and other body systems. female gonads=ovaries, male gonads=testes, gender determined at fertilization, Y chromosome essential for development of testes and hormones |
| How do genitals appear at birth? | preterm femal appear swollen, labia minor amy proturede beyond labia majora, testicles may appear large and may fail to move into the scrotum, possible phimosis |
| T / F Infants are more susceptible to fluid volume excess and dehydration. | true |
| what dx tests are used to assess Genitoruinary tract disfunction? | UA, IVP, CT scan, BUN/Cr, Renal biopsy, cystoscopy, uric acid, creatinine |
| urodynamics | determines the rate of uring flow by volume and pressure. uroflowmetry, cystometrogram, voiding pressure study |
| crzy instructor | 1.5-7yrs old 10-15 mg/kg per 24 hrs, 7-15 yrs 5.2 mg/kg 24 hrs |
| nursing considerations | s/s dysfunction, urine blood specimens, I/O's, |
| : What two procedures assess bladder capacity and function? | Cystometrogram and voiding pressure study |
| What is the nurse primarily responsible for when taking care of a child with GU dysfunction? | The nurse is responsible for Recognizing the signs and symptoms Obtaining the appropriate urine and blood specimens as ordered Maintaining strict I & O. |
| UTI may involve urethra, bladder, kidneys, pelvis, ureters. Why is UTI more common in girls? | Shorter urethra and/or location near anus. Wearing nylon underwear. Use of bubble baths. Urine retention and vaginitis. Incest or other sexual abuse. |
| UTI aspects | 2- 6 yrs, 80% caused by e coli, alkaline urine is breeding ground for pathogens, urine in bladder for extended amounts of time promotes bacteria growth |
| age dependent symptoms of infants? | Fever. Weight loss. Vomiting. Increased voiding. Foul-smelling urine. Persistent diaper rash. |
| older children school age manifestations of UTI? | Urinary frequency. Pain during micturition. Onset of bedwetting. Abdominal or back pain. Hematuria. Vomiting. |
| signs of renal involvement with UTI | Fever. Chills. Flank pain. |
| what are the objectives of treatment | Eliminate current infection. Identify contributing factors to reduce risk of recurrence. Prevent systemic spread of the infection. Preserve renal function. |
| what some aspects of ABX therapy | Initiated on the basis of identification of the pathogen. Child’s history of antibiotic use. Location of infection. |
| common antiinfectives for UTI abx therapy | Pencillins. Sulfonamide (trimethoprim and sulfisoxazole in combination). Cephalosporins. Nitrofurantoin. |
| what is for prevention of UTI | Proper amounts of fluid to flush the bladder. Encourage complete bladder emptying. Remind child to void frequently; anticipate incontinence. Void as soon as they feel the urge |
| What are some other pt teaching pts | Encourage use of showers. Explain the need for cotton underwear. Suggest drinking juices to maintain acidity of urine. females:front to back, avoid bubble baths, softeners, hot tubs, whirlpootl, frequent pad changes during menstration/genital cleansng |
| Parent pt teaching includes? | Teach parents about medications. Instruct parents and children that recurrence is most likely within 1-2 months after infection and is often asymptomatic. Monitor vital signs. Periodic follow-up for urine cultures. |
| Repeated UTIs can result in? | Renal scarring, decreased renal function and can contribute to hypertension as an adult. |
| Recurrence of a UTI is most likely to occur within how many months? | One to two months after termination of treatment |
| what are common urine obstructions? | Calculi (stones). Tumors. Strictures. Scarring. |
| what is hydronephrosis | Hydronephrosis is distention of the renal pelvis because of an obstruction. The pelvis of the kidney becomes enlarged and cysts form. This may eventually damage renal nephrons, resulting in deterioration of the kidneys. |
| Polycystic kidney refers to a condition in which large, fluid-filled cysts form in place of healthy kidney tissue in the fetus. how does it start, cause damage, or result in UTI | from autosomal recessive trait, can result in an inability of the kidney to concentrate urine, resulting in metabolic acidosis. Urine that is not excreted promptly can promote the growth of organisms that causes urinary tract infection. |
| hydronephrosis or other obstructive urophathy Manifestations depend on the cause. what are they? | swollen face, limbs, and distended abdomen |
| what is the treatment? | Urinary diversion. Surgery may cause apprehension in parents. Physical care r/t urinary stoma: |
| what is the stoma care based on? | Hygiene problems. Skin problems. Difficulty with child care or taking care of special needs child |
| what are stressors of urinary diversion for toddlers? | Toddler unable to attain toilet training. |
| what are stressors of urinary diversion for school age children? | School-aged child may have distorted body image. |
| what are stressors of urinary diversion for adolescents? | Adolescent may have lower self-esteem and concern about sexuality. |
| what psychosocial issues are of concern when planning interventions? | Parents of newborn grieve loss of perfect child & concerned about future. Incorporate appropriate psychological interventions into daily care. Emotional support for parents. Teach parents to prevent infections. |
| what is hydronephrosis | Distention of the renal pelvis due to an obstruction. |
| Surgery of the urinary or genital tract impacts growth and development. how does it affect preschoolers? | perceived as punishment, peaked separation anxiety, preventive strategies must be explained to parents, body image must be maintained for surgery delayed beyond infancy |
| 3-6 yr olds in genitourinary surgery | Surgery of the urinary or genital tract impacts growth and development. |
| Adolescents genitourinary surgery | Concerned about effect of surgery on appearance and sexual ability. |
| nursing care for genitourinary surgery | avoid tub baths one week post, keep genital dressings clean/inspected daily, restrict play from straddle (tricycle, rocking horse, sand box) |
| major concerns for genitourinary care | For parents and children is related to surgery and its effect on the genitalia directly. Concerns about size, appearance and the ability to procreate are potential fears that require adjustment, especially with adolescents |
| What type of growth and development impact does surgery of the urinary or genital tract have on a preschooler? | Treatment perceived as punishment, separation anxiety during hospitalization, body image disturbance. |
| Nephrotic syndrome | presence of marked amounts of protein in the urine, edema, and hyperalbuminemia and hyperlipidemia. |
| Minimal change nephrotic syndrome (MCNS), found in approximately what percent of cases. | 80% |
| is nephrotic syndrome more common in what gender, age group, what prognosis, relapse? | More common in males. Most often in children 2-8 years old. Cause unknown. Prognosis: good in steroid-responsive patients. Most pts have periods of relapse until the disease resolves itself. |
Created by:
redhawk101
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