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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
Q

S+S nephrotic syndrome

A

-edema (high risk skin breakdown)
-hypoalbuminemia
-*proteinuria
-hyperlipidemia
-hypovolemia
-severe proteinuria
-weight loss
-pallor

26
Q

Tx nephrotic syndrome

A

-*diet
-corticosteroids
-immunosuppression
-diuretics
-daily weights and skin care

27
Q

Major disorder associated with a
defect in ability to concentrate
urine

A

nephrogenic diabetes insipidus (NDI)

28
Q

S+S NDI in newborn

A

-vomiting
-fever
-failure to thrive
-hypernatremia

29
Q

S+S NDI

A

-copious amounts dilute urine
-growth retardation
-hypernatremia
-extreme thirst

30
Q

Tx NDI

A

-fluid management
-meds: hydrochlorothiazide, DDAVP
-low Na diet

31
Q

S+S hemolytic uremic syndrome (HUS)

A

-acute kidney injury
-hemolytic anemia
-thrombocytopenia
-D/V
-anorexia, lethargic, irritable
-bruising, purpura, rectal bleeding
-elevated BUN and Cr
-HTN
-possible anuria/oliguria

32
Q

causes HUS

A

-shiga toxin
-e coli
-shigella

33
Q

Tx HUS

A

-fluid replacement
-treat HTN
-correct acidosis and electrolyte imbalances
-early hemodialysis
-possible blood transfusion
-enteral nutrition

34
Q

when would a kid with HUS need early hemodialysis

A

-anuric for 24 hrs
-oliguric with uremia or HTN + seizures

35
Q

3 types unexplained proteinuria

A

-transient (with illness, exercise, dehydration)
-persistent (signifies renal disease)
-orthostatic (needs more testing)

36
Q

2 types renal failure

A

acute renal failure (ARF)
chronic renal failure (CRF)

37
Q

S+S acute renal failure

A

-*oliguria
-azotemia
-met acidosis
-electrolyte disturbances (hyperkalemia, hyponatremia, hypocalcemia)

38
Q

most common cause acute renal failure

A

transient renal failure from severe dehydration

39
Q

possible complications of acute renal failure

A

-hyperkalemia
-HTN
-anemia
-seizures
-hypervolemia
-cardiac failure with pulmonary edema

40
Q

possible causes chronic renal failure

A

-congenital
-recurrent UTIs
-chronic pyelonephritis
-chronic glomerulonephritis

41
Q

3 types dialysis

A

-hemodialysis
-peritoneal dialysis (PD)
-hemofiltration

42
Q

accumulation of nitrogenous waste in blood

A

azotemia

43
Q

Tx hyperkalemia

A

calcium gluconate
EKG monitoring

44
Q

S+S chronic renal failure

A

-growth disturbance
-anemia
-low levels calcium and phosphorus
-metabolic acidosis
-hyperkalemia
-water and sodium retention

45
Q

S+S possible rejection from kidney transplant

A

-fever
-swelling and tenderness over graft
-diminished urinary output
-elevated BP
-elevated Cr
-proteinuria, hematuria

46
Q

Urethral opening is located
below the glans penis or
anywhere along the underside
of the penile shaft

A

hypospadias

47
Q

S+S inguinal hernia

A

-pain
-abdominal distention
-anorexia
-difficulty with bowel movement

48
Q

2 types hydrocele

A

communicating: fluid moves from abdominal cavity to scrotum

non-communicating: fluid is enclosed

49
Q

Tx hydrocele
-communicating
-non-communicating

A

communicating: surgery (usually leads to herniation)

non-communicating: self-resolves

50
Q

Failure of the testes to descend
through the inguinal canal to the
scrotum

A

cryptorchidism

51
Q

3 types cryptorchidism

A

-abdominal
-canalicular
-ectopic

52
Q

S+S cryptorchidism

A

-nonpalpable testis
-affected side(s) appear small

53
Q

Tx cryptorchidism
-retractile testis
-undescended testis

A

retractile: self-resolves

undescended:
-leutiniing hormone
-avoid straddled toys
-orchiplexy (surgery) between 1-2 yo

peds (28 decks)

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