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peds > ch 24 and 25 GI elimination and renal dysfunction > Flashcards

ch 24 and 25 GI elimination and renal dysfunction Flashcards

1
Q

differences in renal system in infants

A

-GFR and absorption low until 1-2 yo
-unable to concentrate urine
-unable to reabsorb Na and water
-very dilute urine

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2
Q

normal pH urinalysis

A

5-9pH

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3
Q

normal specific gravity urinalysis

A

1.001-1.035

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4
Q

normal urobilinogen

A

up to 1

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5
Q

what substances should be absent in urinalysis

A

protein
glucose
ketones
Hgb
WBC
RBC
casts
nitrates

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6
Q

normal volume production urine per hour
-newborns
-children

A

newborn: 1-2 mg/kg/hr
child: 1 mL/kg/hr

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7
Q

S+S upper UTI

A

-fever
-chills
-flank pain

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8
Q

2 classifications of upper UTI

A

-pyelonephritis
-glomerulonephritis

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9
Q

S+S lower UTI

A

-no systemic manifestations
-frequency
-chronic constipation
-burning
-urgency

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10
Q

2 classifications lower UTI

A

-cystitis
-urethritis

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11
Q

6 types UTIs

A

-uncomplicated
-complicated
-recurrent
-persistent
-febrile
-urosepsis

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12
Q

causes complicated UTIs

A

-stones
-obstructions
-catheters
-diabetes/neurologic disease
-recurrent infections

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13
Q

S+S UTI in newborn

A

-failure to thrive
-feeding problems
-V/D
-abdominal distention
-jaundice

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14
Q

S+S UTI in kid >2 yo

A

-daytime incontinence
-foul smelling urine
-frequency
-urgency
-abdominal/flank pain

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15
Q

S+S UTI in adolescent

A

-frequency
-urgency
-dysuria
-no fever

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16
Q

med options for complicated UTI (long Tx)

A

-TPM-SMX
-nitrofurantoin
-amoxicillin
-cephalexin
-gentamycin/carbenicillin
-pyridium

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17
Q

meds for repetitive UTIs

A

prophylactic/suppressive Abx
-TMP-SMX everyday

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18
Q

classification of vesicureteral reflex (VUR) - 5 grades

A

grade 1: doesn’t reach renal pelvis
grade 2: up to renal pelvis w/o dilation
grade 3: renal pelvis w/ mild-moderate dilation
grade 4-5: distention of renal pelvis, reflux into intrarenal collecting system

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19
Q

S+S glomerulonephritis

A

-puffiness of face, edema
-dark colored urine (tea/cola colored)
-pale
-irritable, lethargic
-anorexia
-decreased urine output
-mild-moderate elevation in BP
-elevated BUN and Cr
-decreased GFR
-urine contains protein and blood

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20
Q

signs of improving glomerulonephritis

A

increased urine output
decreased BUN and Cr

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21
Q

Tx glomerulonephritis

A

-fluid and Na restrictions
-BP Tx q4-6h
-avoid fatigue
-spontaneous recovery (no specific Tx)

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22
Q

Dx tests for glomerulonephritis

A

-urine analysis
-titers (strep)
-serum complement (C3)

23
Q

what age group gets nephrotic syndrome

A

preschool age

24
Q

precipitating factor causing nephrotic syndrome

A

viral upper resp infection

25
S+S nephrotic syndrome
-*edema (high risk skin breakdown) -*hypoalbuminemia -*proteinuria -hyperlipidemia -hypovolemia -severe proteinuria -weight loss -pallor
26
Tx nephrotic syndrome
-*diet -corticosteroids -immunosuppression -diuretics -daily weights and skin care
27
Major disorder associated with a defect in ability to concentrate urine
nephrogenic diabetes insipidus (NDI)
28
S+S NDI in newborn
-vomiting -fever -failure to thrive -hypernatremia
29
S+S NDI
-copious amounts dilute urine -growth retardation -hypernatremia -extreme thirst
30
Tx NDI
-fluid management -meds: hydrochlorothiazide, DDAVP -low Na diet
31
S+S hemolytic uremic syndrome (HUS)
-acute kidney injury -hemolytic anemia -thrombocytopenia -D/V -anorexia, lethargic, irritable -bruising, purpura, rectal bleeding -elevated BUN and Cr -HTN -possible anuria/oliguria
32
causes HUS
-shiga toxin -e coli -shigella
33
Tx HUS
-fluid replacement -treat HTN -correct acidosis and electrolyte imbalances -early hemodialysis -possible blood transfusion -enteral nutrition
34
when would a kid with HUS need early hemodialysis
-anuric for 24 hrs -oliguric with uremia or HTN + seizures
35
3 types unexplained proteinuria
-transient (with illness, exercise, dehydration) -persistent (signifies renal disease) -orthostatic (needs more testing)
36
2 types renal failure
acute renal failure (ARF) chronic renal failure (CRF)
37
S+S acute renal failure
-*oliguria -azotemia -met acidosis -electrolyte disturbances (hyperkalemia, hyponatremia, hypocalcemia)
38
most common cause acute renal failure
transient renal failure from severe dehydration
39
possible complications of acute renal failure
-hyperkalemia -HTN -anemia -seizures -hypervolemia -cardiac failure with pulmonary edema
40
possible causes chronic renal failure
-congenital -recurrent UTIs -chronic pyelonephritis -chronic glomerulonephritis
41
3 types dialysis
-hemodialysis -peritoneal dialysis (PD) -hemofiltration
42
accumulation of nitrogenous waste in blood
azotemia
43
Tx hyperkalemia
calcium gluconate EKG monitoring
44
S+S chronic renal failure
-growth disturbance -anemia -low levels calcium and phosphorus -metabolic acidosis -hyperkalemia -water and sodium retention
45
S+S possible rejection from kidney transplant
-fever -swelling and tenderness over graft -diminished urinary output -elevated BP -elevated Cr -proteinuria, hematuria
46
Urethral opening is located below the glans penis or anywhere along the underside of the penile shaft
hypospadias
47
S+S inguinal hernia
-pain -abdominal distention -anorexia -difficulty with bowel movement
48
2 types hydrocele
communicating: fluid moves from abdominal cavity to scrotum non-communicating: fluid is enclosed
49
Tx hydrocele -communicating -non-communicating
communicating: surgery (usually leads to herniation) non-communicating: self-resolves
50
Failure of the testes to descend through the inguinal canal to the scrotum
cryptorchidism
51
3 types cryptorchidism
-abdominal -canalicular -ectopic
52
S+S cryptorchidism
-nonpalpable testis -affected side(s) appear small
53
Tx cryptorchidism -retractile testis -undescended testis
retractile: self-resolves undescended: -leutiniing hormone -avoid straddled toys -orchiplexy (surgery) between 1-2 yo

peds (28 decks)

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