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Peak incidence of UTI? 2-6 y/o
Reasons behind UTI incidence of UTI in children? Toilet training, poor hygiene, bubble bath/soaps that irritate the urinary tract.
Retrograde flow of urine into ureters. Vesicoureteral reflux
Constipation can cause UTI T/F? T
Glomerulonephritis commonly occurs after strep throat, how long after strep would you expect to see manifestations of glomerulonephritis? 5-10 days after
S/S of glomerulonephritis *periorbital edema; ascites *HTN *oliguria/proteinuria
S/S of neonate with UTI- select all that apply A. poor feeding B. weight gain C. vomiting D. Respiratory distress E. dysuria F. seizures A, C, D, E, F Also- poor weight gain, Resp distress: increased rr, spontaneous pneumothorax., screaming with urination, dehydration
S/S of UTI in an infant Poor feed, vomit, poor wt gain, dehydration; excess thirst, fever, persistent diaper rash, strain/scream with urination, seizure
S/S of UTI for which age group? *poor appetite; growth failure *vomiting; excess thirst *incontinence; even when previously toilet trained *urinary frequency/urgency *strong smelling urine *blood on tissue Childhood
Recurrent UTI can cause scarring of the urinary tract
Scarring of the urinary tract is often associated with congenital abnormalities
In order to acquire urine for a urinalysis of a child with suspected UTI, would you offer fluids in order to promote urination? No- it would dilute the sample
Presence of nitrites in urine indicates what? Presence of bacteria; causes nitrate conversion to nitrite
Meds given to tx uncomplicated UTI *Bactrim *Amoxicillin *Cephalexin *Pyridium *Urised
Complicated UTI; recur 1-2 months after tx with antibiotics, tx with? 6 week course of ABX or long term ABX
Causes of dysfunctional voiding? UTI, urinary tract abnorms, over active bladder, lazy bladder, small bladder capacity
Functional incontinence Enuresis
Continence never reached Primary incontinence
Secondary incontinence incontinent after 6mos of continence
Management of dysfunctional void *R/O constipation *Is there pain with void? *Void schedule *kegels *anticholinergics *psychological counsel
Meds given for dysfunctional void; helps to decrease uninhibited bladder contractions/increase functional capacity Oxybutynin (Ditropan), Tolterodine (Detrol)
disorder associated with exstrophy of the bladder Epispadias
Malformation of the bladder in which it and related structures are turned inside out exstrophy
When would exstrophy repair be scheduled? 24-48 hours post birth; gender may change time frame
Nursing interventions for Exstrophy? *Monitor urinary output *Monitor signs of urinary tract/wound infection *Mtn integrity of exposed bladder mucosa *Prevent drying of bladder tissue *cover bladder with sterile non-sticky film
S/S of polycystic kidney disease *ABD pain *Hematuria *nocturia
Abnormal flow of urine from bladder back up ureters that connect kidneys to bladder vesicoureteral reflux (VUR)
malformation of the ureterovesical junction and impaired valve VUR
S/S of VUR *urgent feeling of need to void; feel as though bladder isn't empty even after urinating *dysuria *frequent/small voids *hematuria/cloudy urine *fever *ABD or flank pain *hesitancy or holding urine to avoid pain
Test that requires urinating in front of a camera VCUG- voiding cystourethrogram
S/S of nephrotic syndrome *massive proteinuria *hyperlipidemia
What causes the loss of protein in the presence of nephrotic syndrome? Glomerular membrane becomes permeable to protein; causing a fluid shift
Children with NS become symptomatic after respiratory infections and also after... common cold, immunizations, and food allergies.
Why is there an increased risk for clots in nephrotic syndrome? Loss of protein in the blood r/t fluid shift reduces clotting factors.
Normal urine output for newborn? __-__ ml/kg/hr 1-2
Normal urine output for child? __ ml/kg/hr 1
Collaborative management for nephrotic syndrome? *Prednisone; 2mg/kg BID *low-moderate protein diet *Na restriction *cytoxan (immunosuppressant) *diuretics
Creatinine in the blood indicates that what is ocurring? breakdown of muscle should be excreted in urine, if not being excreted this will show up in the blood.
Medical management of nephrotic syndrome? *Ace inhibitors ('prils) *ARB's (sartins)
Why would a patient with SLE or DM be prescribed and ACE or ARB asap? These diseases already cause mild-moderate proteinuria, either of these drugs may prevent proteinuria from increasing, kidney function from worsening.
Symptoms similar to Nephrotic syndrome: *periorbital edema *ascites *peripheral edema *oliguria *wt gain *ARF s/s in addition to hematuria indicates what disease? Hemolytic uremic syndrome
Early symptoms of hemolytic uremic syndrome? *bloody stools, fever, irritable, lethargic, vomiting/diarrhea, weakness
Disorder that usually occurs when an infection in the digestive system produces toxic substances that destroys RBC's causing kidney injury Hemolytic-uremic syndrome
Most common renal/intraabdominal tumor in children. Wilms tumor
First sign generally seen in Wilms Tumor? Mom notices that the diaper won't fit, abdominal protrusion
S/S of Wilms tumor *firm, non-tender unilateral mass *hematuria *fatigue *weight loss *fever *HTN Can compress lungs, causing respiratory distress
Created by: purpleapple87
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