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ATI Pediatrics-MJ > Ch. 26: Renal Disorders > Flashcards

Ch. 26: Renal Disorders Flashcards

1
Q

The glomeruli are inflamed, which impairs the kidney to filter the urine properly

A

Acute glomerulonephritis (AGN)

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2
Q

An antibody antigen disease that occurs as a result of certain trains of the group A b-hemolytic streptococcal infection and is most commonly seen in children between age 2-7

A

Acute post-streptococcal glomerulonephritis (APSGN)

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3
Q

What is risk factor for APSGN?

A

Strep infection with specific strain of group A b-hemolytic strep

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4
Q

What kinda urine is seen with AGN?

A

Cloudy, tea colored and decreased urine output

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5
Q

How is the mood and appearance with AGN?

A

Irritabile and ill appearance, lethargy

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6
Q

How is the eating like with AGN?

A

Anorexia

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7
Q

What kind of discomfort may AGN pts have?

A

Vague–headache, ab pain, dysuria

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8
Q

What kind of edema may be seen with AGN?

A

Periorbital edema

Facial edema that is WORSE in the AM but then spreads to EXTREMITIES and ABDOMEN with progresion of the day

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9
Q

Do AGN pts have cardiac issues?

A

Mild-severe HTN

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10
Q

AGN: What will lab tests show for renal function?

A

Elevated BUN and creatinine

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11
Q

AGN: What test is a positive indicator for presence of strep antibodies?

A

ASO titer

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12
Q

AGN: How often is weight checked?

A

Daily weights—weigh child on same scale with the same amount of clothing daily

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13
Q

AGN: Encourage adequate nutritional intake. What does this mean?

A
  • Possible restriction of Na and fluid
  • Restrict foods high in K during periods of oliguria!!
  • Small, frequent meals of fav foods due to decrease in appetite
  • Avoid added salt and salty foods (ex: chips)

*refer to dietary consulation if necessary

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14
Q

AGN: When would fluids be restricted?

A

Periods of edema and HTN

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15
Q

AGN: What meds may be given? Why?

A

Diuretics and anti-hTN to remove accumulated fluid and manage HTN

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16
Q

AGN: What SE may occur with anti-HTN meds?

A

Dizziness

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17
Q

Alteratons in the glomerular membrane allow proteins (especially albumin) to pass into the urine, resulting in decreased osmotic pressure

A

Nephrotic Syndrome

18
Q

What is peak incidence of MCNS (minimal change neprhrotic syndrome)?

A

2-7 y

19
Q

When does secondaary nephrotic syndrome occur?

A

After or is associated with glomerular damage guess to a known cause

20
Q

Is MCNS have a known cause?

A

No, but may be immune mediated or biochemical

21
Q

**Nephrotic syndrome will be abbreviated= NS

NS: Is there weight gain? Explain.

A

Yes, weight gain over a period of days or weeks

22
Q

NS: What kind of edema?

A

Facial and periorbital edema–decreased throughout day

Edema in the ankles too

23
Q

NS: How is abdomen?

A

Ascites

24
Q

NS: How is nutrition and bathroom stuff?

A

Nutrition: Anorexia

Bathroom stuff: Diarrhea; decreased frothy urine

25
Q

NS: How is mood?

A

Irritable

Lethargy

26
Q

NS: What does BP look like?

A

W/in expected reference range or slightly below

27
Q

**NS: What does the lab test look like for urinalysis/24-hr urine collection? (4)

A

Proteinuria: protein greater than 2+ on dipstick
Hyaline casts
FEW RBC
Oval fat bodies

28
Q

**NS: What does lab test look like for serum chemistry? (5)

A
  • Hypoalbuminemia: reduced serum protein and albumin
  • Hyperlipidemia: Elevated serum lipid levels
  • Hemoconcentration: Elevated Hgb, Hct, and platelets
  • Possible hyponatremia: reduces Na
  • GFR: Normal or high
29
Q

What diagnostic procedure is indicated ONLY if NS is unresponsive to steroid therapy? What will it show?

A

Kidney biopsy

Shows damage to epithelial cells lining basement membrane of kidney

30
Q

NS: How often is child weighted?

A

Daily–weigh child on same scale with the same amount of clothing

31
Q

NS: How often is edema and abdominal girth measured?

A

Daily—measure at the widest area, usually at or above the imbeciles

Assess degree of pitting, color, and texture of skin

32
Q

NS: When would salt and fluids be restricted?

A

During edematous phase

33
Q

NS: What are 4 types of meds that may be given?

A
  1. Corticosteroid: Prednisone
  2. Diuretic: Furosemide
  3. 25% albumin
  4. Cyclophosphamide
34
Q

NS: What are adverse effects of prednisone? When it is administered?

A

AE: Hirsutism, slowed linerar growth, HTN, GI bleeding, infection, hyperglycemia

Administered: With meals

35
Q

NS: What is some client education about furosemide?

A

It eliminated excess fluid from body

Encourage child to eat foods high in K

Monitor serum electrylote levels periodically

36
Q

NS: Why do we give 25% albumin?

A

Increases plasma volume and decreases edema

37
Q

NS: Who would get cyclophosphamide?

A

Children who cannot tolerate prednisone or who have repeated relapses of MCNS

38
Q

What are some complications to NS?

A
  • Sepsis/infection (prednisone increase risk)
  • Circulation insufficiency
  • Thromboembolism
39
Q

A nurse is caring for a child. Which of the following are clinical manifestations of nephrotic syndrome? (SATA)

A. Dipstick protein 1+
B. Edema in ankles
C. Hyperlipidemia
D. Weight loss
E. Anorexia
A

B, C, E

40
Q

A nurse is caring for a child. Which of the following are clinical manifestations of APSGN? (SATA)

A. Frothy urine
B. Periorbital edema
C. Ill appearance
D. Decreased creatinine 
E. HTN
A

B, C, E

41
Q

A nurse is caring for a 10 yr old child who has AGN. Which of the following findings should the nurse report to the provider?

A. Serum BUN 8mg/dL
B. Serum creatinine 1.3 mg/dL
C. BP 100/74
D. Urine output 550mL over 24 hours

A

B

42
Q

A nurse is caring for a 10 year old child who has NS. Which of the following findings should the nurse report to the provider?

A, Serum protein 5.0g/dL
B. HGB 14.5 g/dL
C. HCT 40%
D. Platelet 200,000 mm^3

A

A

ATI Pediatrics-MJ (41 decks)

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