genitourinary (3) Flashcards
3 causes of UTIs
- bacterial
- viral
- fungal
what is a lower UTI called and what does it effect
- cystitis
- urethra and bladder
what is an upper UTI called and what does it effect
- pyelonephritis
- ureters, renal pelvis, renal parenchima
which gender do UTIs effect more
girls
why would a bladder be non-palpable
emptying often
what confirms a UTI
urine C&S
how long are antibiotics taken for UTI
7-14 days
whats conditions involve abnormal location of urethral meatus?
hypospadias and epispadias
is hypospadias dorsal or ventral
ventral
what results from failure of urethral folds to fuse completely over the urethral grove
hypospadias or epispadias
is there a familial tendency or hypo/epispadias
yes
which 4 conditions can occur in conjunction with hypo/epispadias
- congenital cordae
- inguinal hernias
- cryptorchidism (undescended testes)
- partial absebce of foreskin
treatment for hypo/epispadias
- surgical repair, usually wait for circumcision becuase they may use the skin for it in repair
what are the 2 components of hypospadias repair
- new urethral meaus
- stent/catheter in place for urinary drainage
which diapering technique is used after hypospadias surgery
- double diapering
describe double diapering after hypospadias surgery
one diaper is used for stool (underneath), it has a hole in it where a catheter is threaded through to catch urine stream
what is when urine backs up from the bladder into the kidneys due to the ureter opening sitting too low
vesicoureteral reflux
what does vesicoureteral reflux cause
infection
what does increased pressure in the kidneys from vesticoureteral refulx cause
renal scarring, hypertension, possible renal failure
what diagnoses vesticoureteral reflux
voiding cystourethrogram
what is the treatment of vesticoureteral reflux
surgery (ureteral reimplantation, reimplant ureter in another place)
when can patients leave after vesticoureteral reflux surgery
when they can pee on theri own without a foley
what meds are used after vesticoureteral reflux surgery
pain meds, antispasmodics, antibiotics
for what temperature should a parent call the physican after vesticoureteral reflux surgery
greater than 38.5
how long should children avoid acive play after vesticoureteral reflux suregry
3 weeks (hard to comply)
what is repeated involuntary voiding after child is expected to have bladder control (5-6 y.o.)
enuresis
nocturnal vs. diurnal enuresis
nocturnal is only at night, diurnal can be during day too
primary vs. secondary enuresis
- primary= never had a dry night before (always happened)
- secondary= dry for 6-12 months, then it starts. caused by stress, infection, sleep disorder
what type of enuresis is more common
primary
is enuresis more common in girls or boys?
boys
what are the 3 non-pharm treatments for enuresis
- fluid restriction (at night or bedtime)
- bladder training
- enuresis alarms
what are bladder training methods for enuresis
- bladder exercises (start/stop stream)
- timed voiding (q2h, double voiding pattern)
what meds used for enuresis has an antidiuretic effect to decrease urine at night
desmopressin
what meds used for enuresis is a tricyclic antidepressant, has an anticholinergic effect, and stimulates the CNS to allow the child to awake to pee
imipramide
what meds used for enuresis increases bladder capacity
oxybutynin
what is an alteration in kidney function secondary to increased glomerular membrane permeability to plasma protein
nephrotic syndrome
what is characterized by edema, proteinuria, hypoalbuminuria, hypoproteinemia, hyperlipidemia, and altered immunity
nephrotic syndrome
what syndrome affects 85% of children with nephrotic syndrome
minimal change nephrotic syndrome
s/sx of minimal change nephrotic syndrome
- gradual weight gain
- periorbital edema in AM, moves to abd
- generalized edema
- child feels “yucky”
minimal change nephrotic syndrome effects on renal system
decreased output, dark frothy urine
minimal change nephrotic syndrome effects on cardio system
HTN
minimal change nephrotic syndrome vascular effects
thrombosis
minimal change nephrotic syndrome effects on GI system
anorexia, vomiting, abd pain
minimal change nephrotic syndrome effects on skin
pallor, brittle hair, edema, shiny skin, prominent veins
minimal change nephrotic syndrome effects on resp system
resp distress from pulmonary effusion
what is the diagnosis of nephrotic syndrome based on?
- history
- physical
- presence of symptoms
- lab findings
what lab finding are seen in nephrotic syndrome
3-4+ protein in urine
bloodwork
what is the goal of neohrotic syndrome treatment
to get into remission
what med is used to decrease protein in nephrotic syndrome
corticosteroids (IV or PO)
what med for nephrotic syndrome treatment replaces deficiencies and helps edema
IV albumin
what med for nephrotic syndrome treatment induces diuresis
furosemide
what med for nephrotic syndrome treatment controls and prevents infection
antibiotics
nutritional needs of nephrotic syndrome
no added salt
why is it imprtant to continue monitoring nephrotic syndrome after it subsides
relapses
what is inflammation of the glomeruli of the kidneys
acute postinfectious glomerulonephritis
what is APIGN in response to?
group A beta hemolytic strep infection (skin or pharynx)
why does edema happen in APIGN?
kidneys become incapable of filtering and emilinating wastes (sodium and water)
clinical manifestations of APIGN
- abrupt onset
- flank/abd pain
- irritability
- malaise
- fever
- hematuria
- proteinuriary congestion or ascites
- mild periorbital edema
- dependent edema -> pulmonary congestion or ascites
- HTN
what aspects of blood will be increased with APIGN
BUN, creatinine, WBC count, sed rate
what in blood is decreased in APIGN
serum protein, H&H
what does an elevated ASO titer mean for APIGN
shows if they had strep throat (not skin)
what is abnormal in a urinalysis with APIGN
hematuria and proteinuria
what are s/sx of pulmonary congestion in APIGN
dyspnea, resp distress, dull pain, cough, crackles
what activity is ordered for someone with APIGN
bedrest
what is when foreskin cant be retracted over the glans penis. (normal in uncircumsized)
phimosis
what is when retracted forskin wont return to normal position
paraphimosis
what is an emergent condition where the scrotum is twisted, cutting off blood supply to testes. has severe pain and edema in scrotum
testicular torsion
when is surgery needed for testicular torsion
within 6 hrs
what is infection of upper genital tract caused by STIs
pelvic inflammatory disease
s/sx of pelvid inflammatory disease
lower abd pain, dysmenorrhea/ prolonged menses, discharge, pain w/ sex, n/v fever
what does pelvic inflammatory disease lead to?
infertility, ectopic pregnancy, chronic pelvic pain
describe antibiotic treatment for pelvic inflammatory disease
IV 24h, then oral