Chapter 44: The Child with a Genitourinary Alteration

Question 1

kidneys reach near adult function at __________ of age

Answer 1

6-12 months

Question 2

most common cause of chronic renal failure in children

Answer 2

congenital abnormality

Question 3

sudden loss of kidney function

Answer 3

acute renal failure

Question 4

treatment for acute post-streptococcal glomerulonephritis is ____________ and includes monitoring ______________, low-_________ diet, and treatment of ______________.

Answer 4

supportive, fluid and electrolyte balance, sodium, hypertension

Question 5

electrolyte imbalance that can occur with acute post-streptococcal glomerulonephritis if kidney damage is occurring

Answer 5

increased potassium
increased bicarbonate

Question 6

three examples of congenital urinary tract obstructions

Answer 6

stricture
hydronephrosis
phimosis

Question 7

(Circumcised, Uncircumcised) males are at an increased risk of UTIs when the _____________________________

Answer 7

Uncircumcised, foreskin is not cleaned properly

Question 8

Decreased _____________ and increased ___________ levels cause bone issues in patients with chronic renal failure.

Answer 8

calcium, phosphorus

Question 9

UTI manifestations in a(n) (infant, child, child with pyelonephritis) include nonspecific manifestations, fever or hypothermia, irritability, dysuria, change in urine odor or color, and poor weight gain

Answer 9

infant

Question 10

___________________ and ________________ increase the risk of enuresis

Answer 10

emotional stress, sexual abuse

Question 11

irreversible loss of kidney function over months to years

Answer 11

chronic renal failure

Question 12

testes typically descend at _____________ weeks gestation

Answer 12

32-36

Question 13

children, especially (males, females), have (longer, shorter) urethras that predispose them to _______

Answer 13

females, shorter, UTIs

Question 14

to treat nephrotic syndrome, the maximum dose of _____________ (for the patient’s weight) is given until no protein in urine for ________, then maintain dose for __________, then taper off

Answer 14

prednisone, 3-7 days, 4-6 weeks

Question 15

children BEGIN to develop bladder control at ___________ of age

Answer 15

2 years

Question 16

drug that can be used for enuresis unable to be treated by behavioral changes

Answer 16

desmopressin acetate

Question 17

if the teste has not descended by ________ of age, surgery may be needed to pull it down

Answer 17

6-12 months

Question 18

To treat enuresis (not caused by a disease process), behavioral changes include avoiding common _____________ such as ________ or __________, offering frequent opportunities to ________, limiting ________ and altering diet, keeping ________ of voiding, providing guided ___________, ___________ conditioning, and setting voiding ________.

Answer 18

diuretics, sugar, caffeine, void, fluids, records, imagery, behavioral, alarms

Question 19

management of chronic renal failure includes ________ modification and medications such as ___________ and _______________.

Answer 19

diet, diuretics, antihypertensives

Question 20

abnormal lab work for acute renal failure includes abnormal ____________, __________ imbalance, increased _________ and ____________, and fluid volume ________.

Answer 20

electrolytes, acid-base, BUN, creatinine, shifts

Question 21

Manifestations of acute renal failure include _______, decreased _____________, respiratory ________, and increased _________. _________, ____________, and ___________ are manifestations that can occur with abnormal electrolytes.

Answer 21

edema, appetite/feeding, distress, blood pressure
emesis, lethargy, seizures

Question 22

premature male infants have an increased risk of this condition

Answer 22

cryptorchidism

Question 23

urinary _________ during potty training or voiding ______________ can cause urinary ___________ and may cause a _________

Answer 23

retention, dysfunction, stasis, UTI

Question 24

caused as an immune response after a group A strep infection in children

Answer 24

acute post-streptococcal glomerulonephritis

Question 25

six causes of enuresis include decreased _________ capacity, __________ abnormalities, ___________ infection, _____________ bladder, _____s, and __________.

Answer 25

bladder, congenital, pinworm, neurogenic, UTI, constipation

Question 26

occurs from insult to glomerular basement membrane, increasing permeability and loss of substances that normally prevent negatively charged proteins from crossing membrane, excreting negatively charged proteins

Answer 26

nephrotic syndrome

Question 27

manifestations of acute post-streptococcal glomerulonephritis (3)

Answer 27

hypertension, edema, renal insufficiency

Question 28

complete bladder control is achieved by __________ of age

Answer 28

4-5 years

Question 29

Indications for dialysis include severe fluid ______________, pulmonary ________ or congestive ________________ secondary to that stated before, severe ________________, _____________ or _____________ unresponsive to medications, and/or a BUN greater than _______ mg/dL

Answer 29

overload, edema, heart failure, hypertension, metabolic acidosis, hyperkalemia, 120

Question 30

treatment of acute renal failure is based on

Answer 30

identifying and treating cause

Question 31

congenital abnormality that causes urine in the bladder to back up into the ureter and/or kidney (increases risk for UTIs)

Answer 31

vesicoureteral reflux (VUR)

Question 32

characterized by at least one undescended testicle at birth

Answer 32

cryptorchidism

Question 33

the urethral opening is on the dorsal side of the glans of penis

Answer 33

epispadias

Question 34

desmopressin acetate should be avoided under the age of ____

Answer 34

6 years

Question 35

treatment for nephrotic syndrome includes the medications ___________ and _______________ with a low-__________ diet

Answer 35

steroids (prednisone), diuretics, sodium

Question 36

UTI manifestations in a(n) (infant, child, child with pyelonephritis) include high fever, chills, back pain, costovertebral angle tenderness, nausea, vomiting, appears very ill

Answer 36

child with pyelonephritis

Question 37

characteristics of urine with acute post-streptococcal glomerulonephritis (2)

Answer 37

hematuria, proteinuria

Question 38

urinalysis indicates UTI with presence of these four things in urine

Answer 38

bacteria, blood, WBCs, nitrites

Question 39

inability to retract foreskin

Answer 39

phimosis

Question 40

To improve fatigue for secondary anemia caused by chronic renal failure, use the medication ______________.

Answer 40

erythropoietin

Question 41

Manifestations of chronic renal failure are relatively __________ and include decreased ________, failure to _________, _______ issues, and _________.

Answer 41

vague, height, thrive, bone, edema

Question 42

obstruction in ureter backing up urine to kidney

Answer 42

hydronephrosis

Question 43

Adolescent females have an increased risk for UTIs when they ______________________

Answer 43

engage in sexual activity

Question 44

UTI manifestations in a(n) (infant, child, child with pyelonephritis) include abdominal or suprapubic pain, voiding frequency, voiding urgency, dysuria, new or increased incidence of enuresis, and fever

Answer 44

child

Question 45

kidneys operate at a functional level relative to ______________

Answer 45

body size

Question 46

parent teaching to prevent UTIs in children includes frequent __________, avoiding _________, proper ________ (wiping _______ to ________), increasing ___________, wearing _________ underwear, and avoiding _______________.

Answer 46

voiding, holding, hygiene, front, back, clear fluids, cotton, bubble baths

Question 47

To qualify for dialysis or kidney transplant, glomerular filtration rate (GFR) must be between _____%

Answer 47

5-10

Question 48

abnormal narrowing of a passage

Answer 48

stricture

Question 49

commonly known as bed-wetting

Answer 49

nocturnal enuresis

Question 50

Infants concentrate urine (more, less) efficiently than older children or adults

Answer 50

less

Question 51

nocturnal enuresis resolves by ______ of age

Answer 51

5-6 years

Question 52

nocturnal enuresis occurs when children cannot _____________________________

Answer 52

sense a full bladder

Question 53

characterized by urgency, frequency, and inappropriate wetting during the day

Answer 53

diurnal enuresis

Question 54

the urethral opening is on the ventral side of the glans of penis

Answer 54

hypospadias

Question 55

To avoid excess edema with chronic renal failure, decrease __________ and ___________ intake.

Answer 55

sodium, fluid

Question 56

characteristics of urine in nephrotic syndrome

Answer 56

dark and frothy 3+ to 4+ proteinuria

Question 57

manifestations include edema, anorexia, fatigue, abdominal pain, increased weight, respiratory infection, increased H&H

Answer 57

nephrotic syndrome