Chapter 44: The Child with a Genitourinary Alteration Flashcards
kidneys reach near adult function at __________ of age
6-12 months
most common cause of chronic renal failure in children
congenital abnormality
sudden loss of kidney function
acute renal failure
treatment for acute post-streptococcal glomerulonephritis is ____________ and includes monitoring ______________, low-_________ diet, and treatment of ______________.
supportive, fluid and electrolyte balance, sodium, hypertension
electrolyte imbalance that can occur with acute post-streptococcal glomerulonephritis if kidney damage is occurring
increased potassium
increased bicarbonate
three examples of congenital urinary tract obstructions
stricture
hydronephrosis
phimosis
(Circumcised, Uncircumcised) males are at an increased risk of UTIs when the _____________________________
Uncircumcised, foreskin is not cleaned properly
Decreased _____________ and increased ___________ levels cause bone issues in patients with chronic renal failure.
calcium, phosphorus
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
infant
___________________ and ________________ increase the risk of enuresis
emotional stress, sexual abuse
irreversible loss of kidney function over months to years
chronic renal failure
testes typically descend at _____________ weeks gestation
32-36
children, especially (males, females), have (longer, shorter) urethras that predispose them to _______
females, shorter, UTIs
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
prednisone, 3-7 days, 4-6 weeks
children BEGIN to develop bladder control at ___________ of age
2 years
drug that can be used for enuresis unable to be treated by behavioral changes
desmopressin acetate
if the teste has not descended by ________ of age, surgery may be needed to pull it down
6-12 months
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 ________.
diuretics, sugar, caffeine, void, fluids, records, imagery, behavioral, alarms
management of chronic renal failure includes ________ modification and medications such as ___________ and _______________.
diet, diuretics, antihypertensives
abnormal lab work for acute renal failure includes abnormal ____________, __________ imbalance, increased _________ and ____________, and fluid volume ________.
electrolytes, acid-base, BUN, creatinine, shifts
Manifestations of acute renal failure include _______, decreased _____________, respiratory ________, and increased _________. _________, ____________, and ___________ are manifestations that can occur with abnormal electrolytes.
edema, appetite/feeding, distress, blood pressure
emesis, lethargy, seizures
premature male infants have an increased risk of this condition
cryptorchidism
urinary _________ during potty training or voiding ______________ can cause urinary ___________ and may cause a _________
retention, dysfunction, stasis, UTI
caused as an immune response after a group A strep infection in children
acute post-streptococcal glomerulonephritis
six causes of enuresis include decreased _________ capacity, __________ abnormalities, ___________ infection, _____________ bladder, _____s, and __________.
bladder, congenital, pinworm, neurogenic, UTI, constipation
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
nephrotic syndrome
manifestations of acute post-streptococcal glomerulonephritis (3)
hypertension, edema, renal insufficiency
complete bladder control is achieved by __________ of age
4-5 years
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
overload, edema, heart failure, hypertension, metabolic acidosis, hyperkalemia, 120
treatment of acute renal failure is based on
identifying and treating cause
congenital abnormality that causes urine in the bladder to back up into the ureter and/or kidney (increases risk for UTIs)
vesicoureteral reflux (VUR)
characterized by at least one undescended testicle at birth
cryptorchidism
the urethral opening is on the dorsal side of the glans of penis
epispadias
desmopressin acetate should be avoided under the age of ____
6 years
treatment for nephrotic syndrome includes the medications ___________ and _______________ with a low-__________ diet
steroids (prednisone), diuretics, sodium
UTI manifestations in a(n) (infant, child, child with pyelonephritis) include high fever, chills, back pain, costovertebral angle tenderness, nausea, vomiting, appears very ill
child with pyelonephritis
characteristics of urine with acute post-streptococcal glomerulonephritis (2)
hematuria, proteinuria
urinalysis indicates UTI with presence of these four things in urine
bacteria, blood, WBCs, nitrites
inability to retract foreskin
phimosis
To improve fatigue for secondary anemia caused by chronic renal failure, use the medication ______________.
erythropoietin
Manifestations of chronic renal failure are relatively __________ and include decreased ________, failure to _________, _______ issues, and _________.
vague, height, thrive, bone, edema
obstruction in ureter backing up urine to kidney
hydronephrosis
Adolescent females have an increased risk for UTIs when they ______________________
engage in sexual activity
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
child
kidneys operate at a functional level relative to ______________
body size
parent teaching to prevent UTIs in children includes frequent __________, avoiding _________, proper ________ (wiping _______ to ________), increasing ___________, wearing _________ underwear, and avoiding _______________.
voiding, holding, hygiene, front, back, clear fluids, cotton, bubble baths
To qualify for dialysis or kidney transplant, glomerular filtration rate (GFR) must be between _____%
5-10
abnormal narrowing of a passage
stricture
commonly known as bed-wetting
nocturnal enuresis
Infants concentrate urine (more, less) efficiently than older children or adults
less
nocturnal enuresis resolves by ______ of age
5-6 years
nocturnal enuresis occurs when children cannot _____________________________
sense a full bladder
characterized by urgency, frequency, and inappropriate wetting during the day
diurnal enuresis
the urethral opening is on the ventral side of the glans of penis
hypospadias
To avoid excess edema with chronic renal failure, decrease __________ and ___________ intake.
sodium, fluid
characteristics of urine in nephrotic syndrome
dark and frothy
3+ to 4+ proteinuria
manifestations include edema, anorexia, fatigue, abdominal pain, increased weight, respiratory infection, increased H&H
nephrotic syndrome
