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LassanskePEDSRenal
| Question | Answer |
|---|---|
| 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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