Exam 2 - GU Flashcards
when do the kidneys reach near adult functioning level
6-12 y/o
why are children predisposed to UTIs
shorter urethras
when should complete bladder control be achieved
4-5 y/o
can infants concentrate urine as efficiently as older children and adults
No
what is enuresis
involuntary discharge of urine (Tabor’s)
what is nocturnal enuresis
bed-wetting
when is nocturnal enuresis a concern
> 6 y/o
what is diurnal enuresis
urgency, frequency, and inappropriate wetting during the day
primary vs. secondary enuresis
P: child has never had bladder control
S: bladder control at least 6 months, begins wetting again
avoiding caffeine and sugar after ___ will help with nocturnal enuresis
1600
how does DDAVP help with enuresis
synthetic ADH (reduced volume of fluid)
hyponatremia risk
low dose (0.25mg) gradual increase (0.6mg)
DDAVP contraindication
< 6 y/o
how does Tofranil help with enureiss
inhibits urination
only used for 6-8 weeks (must taper)
when to administer Tofranil
1-2 hours before bedtime
Tofranil risk
SI
how does Ditropan (anticholinergic) help with enuresis
decrease bladder contractions
starts at 5 mg daily, can increase to 20 mg daily
Ditropan contraindications
< 5/6 y/o
what is vesicoureteral reflux (VUR)
retrograde urine flow (back flow into kidneys)
UTI can lead to ___ ___ and decrease ___ function
nephrotic scarring; kidney
2 bacterias r/t UTI
E. Coli
group B strep
frequent UTI < 1 can lead to ___
HTN
how many grades of vesicoureteral reflux (VUR) are there?
1-5
1: least invasive (reflux into ureter, no dilation)
5: worst (gross dilation, reflux involves kidneys)
VUR is often a ___ malformation
congenital
s/sx UTI in infants
fever or HYPOtermia***
irritability
dysuria (cries with voiding)
change in urine color, odor
poor weight gain
feeding difficulties
s/sx of UTI in children
abdominal, suprapubic pain
voiding frequency, urgency
dysuria
new or increase enuresis
fever
parent education for UTI
take meds as Rx
wipe front-back
avoid “holding” urine (void 4-5 times daily)
plenty of fluids
cotton underwear
avoid bubble baths
good hygiene for sexually active adolescent girls
epispadias vs. hypospadias
E: urethral opening ABOVE normal location
H: urethral opening BELOW normal location (most common)
when is there a higher incidence of epispadias and hypospadias
if father or brother had
there is usually a ____ issue involved with epispadias
bladder
what is cryptorchidism
at least 1 undescended testicle at birth
greatest risk for premature infants
major risk with cryptorchidism
infertility
lifetime risk of testicular cancer
what is orchiopexy and when it is performed
surgical repair of cryptorchidism
6-12 months
cryptorchidism: retractile vs. ectopic testis
R: descends but retracts with exam and physical stimulation
E: outside of normal pathway (groin, abdomen, perineum)
acute post-strep glomerulonephritis
hematuria ***
proteinuria
HTN
edema
renal insufficiency
acute post-strep glomerulonephritis occurs ___ and ___ ___ on its own
suddenly; resolves completely
which age group is acute post-strep glomerulonephritis most commonly seen
school-aged children
what are some illnesses associated with acute post-strep glomerulonephritis
pharyngitis
strep
impetigo
illnesses occur 1-2 weeks prior to onset
acute post-strep glomerulonephritis: ASO titer
elevated
strep antibodies
acute post-strep glomerulonephritis: RBC, cast, proteinuria
0-3 (small amounts)
acute post-strep glomerulonephritis: albumin, cholesterol, and triglycerides
WNL
acute post-strep glomerulonephritis: H&H
low or WNL
acute post-strep glomerulonephritis: electrolytes, BUN, crt
electrolytes: altered
BUN, Crt: elevated
if BUN is elevated, what should be restricted
protein
when is improvement noted with acute post-strep glomerulonephritis
increase UOP
acute post-strep glomerulonephritis diet
low salt
possible fluid restriction
what is nephrotic syndrome
disorder of renal system
excessive protein is excreted in urine
s/sx of nephrotic syndrome
edema (insidious, rapid onset)
anorexia
fatigue
pallor
abdominal pain
increased weight
respiratory infection
lipid and albumin level with nephrotic syndrome
lipids: high
albumin: LOW in BLOOD; HIGH in URINE
nephrotic syndrome is caused by a ___
virus
nephrotic syndrome is treated with ___
corticosteroids
what 2 age group does nephrotic syndrome effect
toddler, school aged
what should be avoided in the diet of someone with nephrotic syndrome
salt
low salt, low fat, low cholesterol diet
what will parents needs to monitor with nephrotic syndrome
protein levels in urine using a dipstick
what should not be administered to a child receiving corticosteroids
live virus vaccines
acute renal failure is a rapid onset d/t ___ or ___
ischemia; trauma
acute renal failure diet
low salt, low potassium, low protein
what to monitor with acute renal failure
BP
UOP
what is chronic renal failure
irreversible loss of kidney function over months to years
what is the end goal with chronic renal failure
kidney transplant
required for a normal life + growth + development
GFR must be __% to be placed on the transplant list
10%
what is exstrophy of the bladder
bladder is exposed outside of the body through an opening in the lower abdominal wall
does the bladder store urine with exstrophy of the bladder
No, bladder and urethra are not closed so it drains into an open area
what is hydrocele
collection of fluid in the scrotal sac
hydrocele treatment
usually resolves on its own by 1 year, sx if not
what is testicular torsion
spermatic cord twists, cutting off the testicles blood supply
requires immediate surgery
what is phimosis
foreskin can not be retracted
what is phimosis r/t
infection
inflammation
congenital
how to treat phimosis
circumcision
what is paraphimosis
retracted foreskin can not be returned to its normal position
s/sx of paraphimosis
blue discoloration of glands, foreskin
edema
what risk is associated with paraphimosis
necrosis to penis
