LassanskePEDSRenal
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| Peak incidence of UTI? | 2-6 y/o
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| Reasons behind UTI incidence of UTI in children? | Toilet training, poor hygiene, bubble bath/soaps that irritate the urinary tract.
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| Retrograde flow of urine into ureters. | Vesicoureteral reflux
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| Constipation can cause UTI T/F? | T
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| Glomerulonephritis commonly occurs after strep throat, how long after strep would you expect to see manifestations of glomerulonephritis? | 5-10 days after
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| S/S of glomerulonephritis | *periorbital edema; ascites
*HTN *oliguria/proteinuria
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| 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
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| 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
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| 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
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| Recurrent UTI can cause | scarring of the urinary tract
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| Scarring of the urinary tract is often associated with | congenital abnormalities
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| 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
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| Presence of nitrites in urine indicates what? | Presence of bacteria; causes nitrate conversion to nitrite
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| Meds given to tx uncomplicated UTI | *Bactrim *Amoxicillin *Cephalexin *Pyridium *Urised
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| Complicated UTI; recur 1-2 months after tx with antibiotics, tx with? | 6 week course of ABX or long term ABX
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| Causes of dysfunctional voiding? | UTI, urinary tract abnorms, over active bladder, lazy bladder, small bladder capacity
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| Functional incontinence | Enuresis
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| Continence never reached | Primary incontinence
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| Secondary incontinence | incontinent after 6mos of continence
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| Management of dysfunctional void | *R/O constipation *Is there pain with void? *Void schedule *kegels *anticholinergics *psychological counsel
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| Meds given for dysfunctional void; helps to decrease uninhibited bladder contractions/increase functional capacity | Oxybutynin (Ditropan), Tolterodine (Detrol)
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| disorder associated with exstrophy of the bladder | Epispadias
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| Malformation of the bladder in which it and related structures are turned inside out | exstrophy
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| When would exstrophy repair be scheduled? | 24-48 hours post birth; gender may change time frame
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| 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
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| S/S of polycystic kidney disease | *ABD pain
*Hematuria
*nocturia
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| Abnormal flow of urine from bladder back up ureters that connect kidneys to bladder | vesicoureteral reflux (VUR)
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| malformation of the ureterovesical junction and impaired valve | VUR
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| 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
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| Test that requires urinating in front of a camera | VCUG- voiding cystourethrogram
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| S/S of nephrotic syndrome | *massive proteinuria *hyperlipidemia
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| What causes the loss of protein in the presence of nephrotic syndrome? | Glomerular membrane becomes permeable to protein; causing a fluid shift
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| Children with NS become symptomatic after respiratory infections and also after... | common cold, immunizations, and food allergies.
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| Why is there an increased risk for clots in nephrotic syndrome? | Loss of protein in the blood r/t fluid shift reduces clotting factors.
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| Normal urine output for newborn? __-__ ml/kg/hr | 1-2
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| Normal urine output for child? __ ml/kg/hr | 1
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| Collaborative management for nephrotic syndrome? | *Prednisone; 2mg/kg BID
*low-moderate protein diet
*Na restriction
*cytoxan (immunosuppressant)
*diuretics
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| 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.
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| Medical management of nephrotic syndrome? | *Ace inhibitors ('prils)
*ARB's (sartins)
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| 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.
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| 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
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| Early symptoms of hemolytic uremic syndrome? | *bloody stools, fever, irritable, lethargic, vomiting/diarrhea, weakness
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| Disorder that usually occurs when an infection in the digestive system produces toxic substances that destroys RBC's causing kidney injury | Hemolytic-uremic syndrome
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| Most common renal/intraabdominal tumor in children. | Wilms tumor
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| First sign generally seen in Wilms Tumor? | Mom notices that the diaper won't fit, abdominal protrusion
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| S/S of Wilms tumor | *firm, non-tender unilateral mass
*hematuria *fatigue *weight loss *fever *HTN
Can compress lungs, causing respiratory distress
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