Exam 4 Flashcards
(170 cards)
Etiology and Pathophysiology of UTI
Mostly caused by E. coli
Urinary stasis can contribute to development
Stasis may be caused by abnormal anatomical structures or abnormal function (e.g. neurogenic bladder)
Clinical Manifestations of UTI
Many are asymptomatic and discovered accidentally on routine examination
Bladder Exstrophy
Rare congenital defect in which the posterior bladder wall extrudes through the lower abdominal wall
Corrected with surgical reconstruction
Obstructive Uropathy
Structural or functional abnormalities of the urinary system that interfere with urine flow and result in urine backflow into the kidneys
Often causes hydronephrosis
Early diagnosis and treatment prevents kidney damage and deterioration of kidney function
Vesicoureteral Reflux
Retrograde flow of urine from the bladder into the ureters
Creates a reservoir for bacterial growth
Recurrent infection within 1-2 months
Culture and sensitivity every 2-3 months
Prune Belly Syndrome
Congenital defect characterized by failure of the abdominal musculature to develop
Primary Enuresis
Child has never had a dry night; attributed to maturational delay and small functional bladder
Not associated with stress or psychiatric cause
Secondary Enuresis
Child who has been reliably dry for at least 6 months begins bed-wetting
Associated with stress, infections, and sleep disorders
Milestones in the Development of Bladder Control
1.5 years: child passes urine at regular intervals
2 years: child announces when voiding is taking place
2.5 years: child makes known the need to void; can hold urine
3 years: child goes to the bathroom alone; holds urge if preoccupied with play
2.5-3.5 years: child achieves nighttime control
4 years: child shows great interest in going to bathrooms when away from home
5 years: child voids approximately 5-6 times per day; prefers privacy; is able to initiate emptying of bladder at any degree of fullness
Nephrotic Syndrome
Alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein
Characterized by edema, massive proteinuria, hypoalbuminemia, hypoproteinemia, hyperlipidemia, and altered immunity
Acute Postinfectious Glomerulonephritis
Most common inflammation of the glomeruli of the kidneys
Many children are asymptomatic
Onset usually abrupt with flank or midabdominal pain, irritability, malaise, and fever
Treatment focuses on relief of symptoms and supportive therapy
Acute Renal Failure
Sudden loss of adequate renal function in which the kidneys are unable to clear metabolic wastes and to regulate extracellular fluid volume, sodium balance, and acid-base homeostasis
Causes of Acute Renal Failure
Hemolytic-uremic syndrome, acute glomerulonephritis, sepsis, poisoning, nephrotoxic medications, hypovolemia, obstructive uropathy, and complication of cardiac surgery
Clinical Manifestations and Treatment of Acute Renal Failure
Dark urine or gross hematuria, headache, edema, fatigue, crackles, gallop heart rhythm, hypertension, hematuria, lethargy, nausea and vomiting, oliguria
Treatment depends on the underlying cause of the renal failure
Chronic Renal Failure
Progressive, irreversible reduction in kidney function
Usually results from developmental abnormalities of the kidney or urinary tract, obstructed urine flow and reflux, hereditary diseases such as polycystic kidney disease, infections such as hemolytic-uremic syndrome, and glomerulonephritis
Clinical Manifestations and Treatment of Chronic Renal Failure
Fatigue, malaise, poor appetite, nausea and vomiting, failure to thrive, short stature, oliguria/polyuria, headache, decreased mental alertness/ability to concentrate, chronic anemia, hypertension, edema, fractures with minimal trauma, rickets, valgus deformity
Treatment is dialysis and eventually a kidney replacement
Hemolytic-Uremic Syndrome
Most common cause of acute renal failure in young children
Triad of signs includes hemolytic anemia, thrombocytopenia, and acute renal failure
Treatment focuses on the complications of ARF and includes fluid restrictions and a high-calorie, high-carbohydrate diet that is low in protein, sodium, potassium, and phosphorus
Polycystic Kidney Disease
Genetic disorder that has autosomal recessive and dominant forms
Liver abnormalities are associated with both forms of the disease
Low-set ears, small jaw, and flattened nose
Treatment is supportive
Cryptorchidism
Undescended testes
Congenital defect of the gonads
Surgery may be necessary for correction
Pelvic Inflammatory Disease
Serious infection of the upper genital tract caused by the ascending spread of organisms in the cervix and vagina
Clinical Manifestations and Treatment of Pelvic Inflammatory Disease
Fever, mild/dull bilateral lower abdominal pain, dysmenorrhea, dysuria, vaginal discharge, prolonged or increased menstrual bleeding
Antibiotics used for treatment
Normal BUN
5-18
Normal CRE
- 2-0.4 in infants
0. 3-0.7 in children
Confusion
Disorientation to time, place, or person; loss of clear thinking. Answers to simple questions may be correct, but responses to complex ones may be inaccurate