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Nursing > Genitourinary, Renal, Endocrine > Flashcards

Genitourinary, Renal, Endocrine Flashcards

1
Q

Renal/urinary system purpose

A
  • Remove metabolic waste
  • Regulate fluid balance
  • Regulate electrolyte balance
  • Regulate acid–base balance
  • Regulate blood pressure
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2
Q

renal/urinary stystem structures

A
  • Kidneys
  • Ureters
  • Urethra
  • Bladder
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3
Q

Glomerular filtration

A

Water and solute are filtered from the capillaries of the glomerulus to the interstitial space of Bowman’s capsule

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4
Q

Reabsorption

A

Water or solute is transferred from the

renal tubules to blood

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5
Q

Secretion

A

Water or solute is transferred from the

blood to the renal tubules

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6
Q

Excretion

A

Elimination of waste from the body.

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7
Q

Renin-angiotensin

A

Renin is secreted by the kidney to stimulate formation production of angiotensin, which causes blood vessels to constrict and increase blood pressure.

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8
Q

Aldosterone

A

Secreted by the adrenal cortex to increase sodium and water reabsorption from the renal tubules. Also assists with maintenance of K+ balance and pH balance.

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9
Q

Antidiuretic hormone (ADH)

A

Released from the posterior pituitary to promote water retention by increasing the permeability of renal tubules to water for reabsorption.

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10
Q

Bladder Capacity-newborn

A

1 to 2 oz

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11
Q

Bladder Capacity-Children

A

(oz) = age (yrs) + 2

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12
Q

Kidneys will___in size from birth to one-year of age.

A

Triple

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13
Q

Infants urine vs. adults

A

does not concentrate urine as efficiently

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14
Q

Infant glomerular filtration

A

Slower and less efficient.
Unable to dispose of excess water and solutes in a rapid or efficient manner.
Susceptible to “water intoxication” and electrolyte imbalance.

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15
Q

Pediatric acid secretion

A

Inefficient until one-year of age.

Serum pH is lower in infants than young children, vulnerable to acidosis.

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16
Q

Pediatric loop of henle

A

Shorter in infants than adults.

Less able to reabsorb sodium which can be a problem if the child is losing excessive sodium due to vomiting or diarrhea.

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17
Q

Pediatric urinary obstruction & infection

A

results in scarring and irreversible kidney damage more quickly in young children due to immaturity of renal parenchyma.

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18
Q

Infants higher metabolic rate

A

Have higher rate than adults causing them to excrete proportionately more metabolic waste via kidneys, possible fluid loss

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19
Q

Phimosis

A
  • Narrowing or stenosis of the opening of the foreskin
  • Normal finding in infants and young boys
  • Can obstruct flow of urine
  • Cause inflammation or infection of foreskin
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20
Q

Phimosis-Nursing care

A
  • Thorough and consistent hygiene

- Do not forcibly retract foreskin (can result in paraphimosis)

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21
Q

Hydrocele

A
  • Fluid-filled sac around a testicle, that results in scrotal swelling.
  • Noncommunicating form is common in newborns. Often resolves spontaneously in first year of life.
  • Communicating form varies in size and may not be reducible. Surgical repair may be needed.
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22
Q

Hydrocele- nursing care

A

Instruct parents that most hydrocele resolve spontaneously

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23
Q

Hypospadias

A
  • Urethral opening is located below the glans penis or anywhere on the ventral surface
  • Incidence is 1 out of 250 live births
  • Goals of surgical correction are to enable the child normal voiding and to preserve sexual functioning
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24
Q

Hypospadias- nursing care

A
  • Inspect all male newborns for presence of hypospadias

- Teach parents post-operative care, including care of indwelling catheters, stents, or irrigation if indicated

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25
Ambiguous genitalia
- Disturbance in the normal events of gender determination - Abnormal gender determination - Abnormal differentiation of gonads - Abnormal differentiation of ductal systems - Abnormal secretion of androgen (congenital adrenal hyperplasia), or tissue insensitivity to hormone
26
Ambiguous genitalia-nursing care
- Support parents in participation with the multidisciplinary team in making gender assignment - Assist parents in understanding the process and importance of careful gender assignment – may be at the expense of rapidness
27
Vesicoureteral Reflux
Retrograde flow of urine from the bladder into the ureter. Most common cause of pyelonephritis in children.
28
Vesicoureteral reflux- primary (congenital)
- Abnormal tunneling of ureteral segment or defects in ureter orifice - Significant familial pattern and high incidence in siblings. Reflux can be asymptomatic, so all siblings should be screened!
29
Vesicoureteral Reflux-secondary (acquired)
- UTI can produce temporary reflux | - Neuropathic bladder with poor compliance
30
Vesicoureteral Reflux- nursing care
- Goal is to prevent infection and scarring | - Support parents in adherence to medical therapy (chronic antibiotics and frequent evaluation of urine for infection)
31
Signs & symptoms of obstructive uropathy
- UTI - Hematuria - Nausea - Flank pain (renal colic) - Dysfunctional voiding patterns
32
UTI risk factors
- Urinary statsis** - Children 2-6 yo - Females
33
UTI-recurrent
Repeated episodes of bacteriuria
34
UTI-persistent
Despite antibiotic treatment bacteriuria persists
35
UTI-febrile
Bacteriuria with fever; implies pyelonephritis
36
Cystitis
Infalmmation of the bladder
37
Urethritis
Inflammation of the urethra
38
Pyelonephritis
Inflammation of the upper urinary tract and kidney
39
Urosepsis
systemic signs of bacterial illness with UTI
40
UTI-nursing care
- Primary goal is prevention - Proper wiping technique - Avoid tight clothing and diapers - Encourage generous fluid intake - Avoid constipation - Avoid “holding” urine and allow time for complete emptying of bladder
41
signs of UTI
- Incontinence in a toilet-trained child - Observance of strong-smelling urine - Observance of frequency or urgency of urination - Pain on urination
42
Acute glomerulonephritis (AGN)
- A post-infectious, immune-complex condition associated with a combination of symptoms. - Glomerular capillaries are injured, results in a reduction in glomerular filtration rate.
43
Acute glomerulonephritis symptoms
- Oliguria - Edema - Hypertension - Circulatory congestion - Hematuria - Proteinuria
44
AGN complications
- Hypertensive encephalopathy and cerebral edema - Acute cardiac decompensation due to hypervolemia - Acute renal failure (ARF)
45
AGN-course of illness
10 days to 3 week acute phase, followed by diuresis phase
46
AGN-nursing care
- Close monitoring of vital signs, fluid balance, and child’s appearance for early signs of complications and severity of disease. - Daily weight is the best indicator of fluid balance - Assessment of cerebral complications - Assessment of early renal failure
47
Assessment of cerebral complications
irritability, change in level of consciousness, listlessness, hypertension.
48
Assessment of early renal failure
hyperkalemia, hyperphophatemia, uremia, excessive blood urea nitrogen (BUN) and elevated creatinine, oliguria or anuria, metabolic acidosis.
49
Nephrotic syndrome
A number of distinct glomerular diseases with increased glomerular permeability which results in massive proteinuria, hypoalbuminemia, hyperlipidemia and edema
50
Types of nephrotic syndromes
- Minimal Change Nephrotic Syndrome (80% of cases in children) - Secondary Nephrotic Syndrome (results of AGN) - Congenital Nephrotic Syndrome (autosomal recessive genetic disorder)
51
Nephrotic syndrome- nursing care
- Strict daily monitoring of weight, vital signs, and I & O (with daily weight best indicator of fluid balance) - Measurement of abdominal girth - Monitoring urine output, color, and presence of protein - Meticulous skin care – particularly skin folds - Preventive measures to avoid infections, e.g. URI - Monitor for spontaneous peritonitis - Good nutrition via attractive meal planning - Developmental and family support
52
Acute renal failure
Sudden inability of the kidneys to regulate volume and composition of urine. - Oliguria - Azotemia - Acidosis - Diverse electrolyte disturbances - Not common in children
53
Enuresis
Involuntary passage of urine into the bed during sleep or into clothing during daytime hours at least twice a week for 3 months in children at least 5 years of age. Usually resolves between ages 6 and 8 years
54
Primary enuresis
Never achieved continence
55
Secondary enuresis
Onset of wetting after having achieved continence
56
Enuresis-causes
- Urinary tract infection that is undetected - Genetic predisposition - Familial tendency - Emotional or behavioral factors
57
Enuresis-nursing care
- Assess for physiologic cause - Support and respect the child and parents - Support treatment plans (audible alarms, medications, behavioral therapies) - Help child manage treatment expectations and provide consistency in the process.
58
Encopresis
Repeated voluntary or involuntary passage of feces of normal or near normal consistency in inappropriate places at least once per month for 3 months after the age of 4 years.
59
Primary encopresis
never achieved continence
60
Secondary encopresis
after established fecal continence
61
Encopresis-causes
- Constipation due to stressors in the environment and withholding stooling - Chronic and severe constipation resulting in fecal obstruction - Abnormalities of the digestive tract (rectal prolapse) - Medical conditions [CP, MD, irritable bowel syndrome (IBS)] - Fear-panic disorders leading to learned abnormal defecation patterns
62
Encopresis-nursing care
- Thorough history and care is directed toward cause of soiling - Education about normal digestive patterns and defecation - Bowel retraining - Correction of impaction - Positive reinforcement - Family plan and follow-up - Support and non-judgmental attitude
63
Endocrine system-3 components
- Hormones chemical messenger - Target cells or end organs receive the chemical message - Functionality of the body’s internal environment – blood, lymph tissue, extracellular fluid
64
Endocrine system
- An interrelationship between the endocrine and autonomic nervous system makes up the neuroendocrine system. - Autonomic nervous system is made up of the Sympathetic and Parasympathetic nervous system - Malfunction in one gland or system may have negative effects elsewhere in the body
65
Major endocrine glands
- Pituitary (anterior and posterior lobes) - Thyroid - Parathyroid - Adrenal - Ovaries - Testes - Islets of Langerhans
66
Minor endocrine glands
- Pineal - Thymus - Gastrointestinal glands - Placenta
67
Assessment of early renal failure
hyperkalemia, hyperphophatemia, uremia, excessive blood urea nitrogen (BUN) and elevated creatinine, oliguria or anuria, metabolic acidosis.

Nursing (22 decks)

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