Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 406 > Exam 1: Genitourinary > Flashcards

Exam 1: Genitourinary Flashcards

1
Q

Genitourinary System Differences

A
  • Healthy infant, kidneys operate at functional level appropriate for body size (however function is reduced when the infant is under stress)
  • By 6-12 months, kidney function is nearly that of an adult
  • Young infant kidneys cannot concentrate urine as efficiently as those of older children and adults. Susceptibility to acemia.
  • Neonates bladder, which is in lower abdominal cavity, gradually sinks into pelvic cavity during early childhood.
  • Young children have shorter urethral, predisposing them to UTI’s.
  • Unlike adults, most children with acute renal failure regain normal function.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do children gain complete bladder control?

A

4-5 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why are young infant’s kidney not able to concentrate urine as efficiently as those of older children and adults?

A
  • Because loops of Henle are not long enough to reach inner medulla.
  • After few weeks of life, ability of kidneys to acidify urine reaches adult levels.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nephrotic Sydrome clinically includes

A
  • Massive proteinuria
  • Hypoalbuminemia
  • Hyperlipidemia
  • Edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Two Types of Nephrotic Syndrome

A
  1. Primary: restricted to glomerular injury

2. Secondary: Develops as a part of systemic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are clinical manifestations of nephrotic syndrome?

A
  • Weight gain
  • Puffiness in the face
  • Edema → intestinal mucosa, abdominal
  • Urine → decreased volume, darkly opalescent and frothy ( a lot of bubbles)
  • Skin pallor
  • Irritability
  • Increased susceptibility to infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnostic symptoms of nephrotic syndrome

A
  • Massive proteinuria
  • High specific gravity
  • Elevated cholesterol & platelet count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for Nephrotic Syndrome

A

Corticosteroid therapy

  • PO for 3 months straight
  • DO NOT STOP ABRUPTLY
  • May become dependent
  • Many side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nephrotic Syndrome relapses can occur if

A

Response to corticosteroid therapy is poor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nursing care for nephrotic syndrome

A
  • Monitor intake and output daily
  • Monitor for skin breakdown → change diapers frequently and change positions frequently
  • Susceptible to upper respiratory tract infections → steroids bring resistance down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vesicoureteral Reflux

A
  • Retrograde of bladder urine into the ureters: the urine that is supposed to be stored in the bladder is now going back up through the ureters.
  • Most common cause of pyelonephritis in children.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of Grade I and II Vesicoureteral Reflux

A
  • Conservative therapy with continuous low-dose ABT and frequent urine cultures (as long as they don’t have continuous UTIs).
  • Usually high incidence of spontaneous resolution (children are small and the ureters may form a loop near the bladder but as they grow older the ureters will straighten out)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of Grade III Vesicoureteral Reflux

A

Management conservatively unless complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of Grade IV and V Vesicoureteral Reflux

A

-Surgical correction is required: surgery will place ureters higher up on the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hypospadius

A
  • Urethral opening that is located below the glans penis.

- Can be anywhere along the ventral surface.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Characteristics of Hypospadius

A
  • Foreskin is usually absent ventrally.
  • May have undescended testes.
  • May be mistaken for female genitalia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Surgical Repair of Hypospadius

A
  • Do not circumcise → the skin from the circumcision will be used in the repair
  • Urinary diversion may be necessary after repair → avoid tub baths until recovered, never clamp together
  • Avoid certain toys especially right after surgery (i.e ride along toys)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HUS (Hemolytic Uremic Sydnrome) is an acute disease characterized by a triad of manifestations including:

A
  • Acute renal failure
  • Hemolytic Anemia
  • Thrombocytopenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hemolytic Uremic Syndrome (HUS) is caused by

A
  • No causative agents identified -> many pathogens associated.
  • Usually follows URI or GI disease.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical Manifestations of HUS

A
  • Episode of diarrhea and vomiting
  • Anorexia
  • Irritable & Lethargic
  • Pallor
  • Bruising, purpura, rectal bleeding
  • Anuria
  • HTN
  • Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is HUS diagnosed?

A
  • Triad is sufficient for diagnosis → proteinuria, hematuria, elevated creatinine and BUN
  • Urinary casts
  • Low Hgb and Hct
  • High reticulocyte count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of HUS

A
  • Recognize what it is that is going on and counteract it. If this is done, there is 95% change of full recovery
  • Fluid replacement
  • HTN treatment
  • Correction of acidosis and electrolyte imbalance
  • Hemodialysis
  • Blood transfusions
  • TPN
  • Symptom treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Glomerulonephritis

A
  • Immune complex disease

- Most cases are post infectious associated with pneumococcal, streptococcal and viral infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Glomerulonephritis: Latent period

A

10-14 days after infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Glomerulonephritis Incidence

A
  • Primarily affects school-age children; peak onset 6-7 y/o; uncommon in <2 years.
  • Most common in winter and spring.
  • Second attacks are rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Glomerulonephritis: The kidneys

A
  • Appears normal to moderately enlarged.
  • Decreased GFR
  • Microscopic exam: diffuse proliferations and exudative process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Clinical Manifestations of Glomerulonephritis

A
  • Facial puffiness
  • Edema that is prominent in the face in the morning and spreads to the extremities and abdomen as the day progresses.
  • Anorexia
  • Urine that is cola-colored, cloudy and decreased in volume
  • Paleness
  • Irritability
  • Headaches
  • Abdominal discomfort
28
Q

How long does glomerulonephritis persist for?

A

4-10 days

29
Q

How can glomerulonephritis affect BP?

A

-Blood pressure may rise

30
Q

What is a sign of improvement of glomerulonephritis?

A

-Increase in urine output

31
Q

Evaluation of Glomerulonephritis

A
  • UA
  • Culture
  • Labs
32
Q

Major Complications of Glomerulonephritis

A
  • Hypertensive enchepalopathy
  • Acute cardiac decompensation
  • Acute renal failure (Most children obtain complete recovery → recover spontaneously)
33
Q

Treatment for Glomerulonephritis

A
  • ABT only if infection is present

- Antihypertensives

34
Q

Management of Glomerulonephritis

A
  • Sodium and water restriction is useful
  • Monitor BP q4-6 hours
  • Restrict foods high in K
35
Q

Acute Renal Failure

A
  • Usually reversible

- Prevention is key

36
Q

Most common cause of acute renal failure in children

A
  • Dehydration

- Other cause of poor perfusion that respond to fluid restoration

37
Q

What are primary manifestations of acute renal failure?

A
  • Oliguria

- < 1mg/kg/hr

38
Q

Management of Acute Renal Failure

A
  • Avoid nephrotoxic drugs

- Monitor/assess fluid and electrolyte balance

39
Q

Chronic Renal Failure

A

Onset is gradual

40
Q

Most common causes of chronic renal failure include

A
  • congenital renal disease,
  • urinary tract malformations
  • vesicoureteral reflux
41
Q

What is the most reliable indicator for chronic renal failure?

A

Creatinine

42
Q

Treatment for Chronic Renal Failure

A

Dialysis or Transplantations

43
Q

Consequences of Chronic Renal Failure

A
  • Delayed growth or absent sexual maturation
  • Risk for infection
  • School may be difficult
  • Social isolation
  • Allow children to set their own activity limits
44
Q

Nocturnal Enuresis

A

Occurs at nighttime during sleep

45
Q

Diurnal Enuresis

A

Occurs during waking hours

46
Q

Primary Enuresis

A

A child never having experienced a period of dryness (never able to potty train)

47
Q

Secondary Enuresis

A

Onset of wetting after urinary continence is established

48
Q

Enuresis Cause/Incidence

A
  • No single cause

- Occurs more frequently in boys

49
Q

Evaluation of Enuresis

A
  • H&P
  • Urinalysis
  • Urine Culture
  • Glucose Test (looks for diabetes)
  • Bladder ultrasound/VCUG (looks for structural issues)
50
Q

Management of Enuresis

A
  • Limiting fluids after dinner
  • Avoid sugar and caffeine intake after 4pm
  • Reward systems
  • Behavioral conditioning
  • Voiding frequently
51
Q

Urinary Tract Infection

A

-May be present with or without symptoms

52
Q

UTI: Incidence

A

-Peak incidence 2-6 yrs: Not caused by structural anomalies

53
Q

Who has the highest risk for UTI’s?

A
  • Uncircumcised males <3 months

- Females <12 months

54
Q

What organisms can cause UTI’s?

A

E-coli and other gram negative organisms

55
Q

If the first urinary tract infection occurs during infancy, there is a

A

Greater chance for renal scarring

56
Q

What can cause UTI’s?

A
  • Dysfunctional voiding
  • Urinary stasis
  • Presence or absence in foreskin contributes
57
Q

What increases the risk for UTI’s?

A
  • Pregnancy
  • Intermittent constipation
  • Short-term indwelling catheters
  • Tight clothing or diapers
  • Poor hygiene
  • Sexual intercourse
58
Q

Clinical Manifestations of UTI’s in Neonates

A
  • Irritability
  • Poor feeding
  • Respiratory distress
  • Screaming with urination
59
Q

Clinical Manifestations of UTI’s in Infancy

A
  • Vomiting
  • Persistent diaper rash
  • Dehydration
60
Q

Clinical Manifestations of UTI’s in Childhood

A
  • Poor appetite
  • Excessive thirst
  • Frequent/painful urination
  • Bloody urination
61
Q

UTI: Diagnostics

A
  • UA: cloudy/hazy; thick noticeable strands of mucous; fishy smell
  • Culture: presence of bacteria (make sure a sterile specimen was collected)
62
Q

Management Goals for UTI’s

A
  • Eliminate current infection
  • Identify contributing factors to reduce reoccurrence
  • Prevent urosepsis
  • Preserve renal function
63
Q

Treatment for UTI’s

A
  • ABT based on culture results

- Surgical correction for anatomical defects

64
Q

Management of UTI’s

A
  • Collect specimen prior to starting antibiotics
  • Ultrasound and VCUG
  • Encourage fluid intake and avoid caffeine/carbonation.
65
Q

Admission Criteria for UTI’s

A
  • Age <60 days
  • Patient is toxic or ill appearing
  • Patient is dehydrated or unable to retain oral fluids
  • Pain requiring parental narcotics
  • Patient with known or suspected genitourinary anomalies
  • Failure of outpatient management
  • Uncertainty about outpatient compliance or primary care provider availability

NURS 406 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions