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Nursing > Genitourinary, Renal, Endocrine > Flashcards

Genitourinary, Renal, Endocrine Flashcards

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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
Q

Ambiguous genitalia

A
  • 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
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26
Q

Ambiguous genitalia-nursing care

A
  • 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
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27
Q

Vesicoureteral Reflux

A

Retrograde flow of urine from the bladder into the ureter. Most common cause of pyelonephritis in children.

28
Q

Vesicoureteral reflux- primary (congenital)

A
  • 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
Q

Vesicoureteral Reflux-secondary (acquired)

A
  • UTI can produce temporary reflux

- Neuropathic bladder with poor compliance

30
Q

Vesicoureteral Reflux- nursing care

A
  • Goal is to prevent infection and scarring

- Support parents in adherence to medical therapy (chronic antibiotics and frequent evaluation of urine for infection)

31
Q

Signs & symptoms of obstructive uropathy

A
  • UTI
  • Hematuria
  • Nausea
  • Flank pain (renal colic)
  • Dysfunctional voiding patterns
32
Q

UTI risk factors

A
  • Urinary statsis**
  • Children 2-6 yo
  • Females
33
Q

UTI-recurrent

A

Repeated episodes of bacteriuria

34
Q

UTI-persistent

A

Despite antibiotic treatment bacteriuria persists

35
Q

UTI-febrile

A

Bacteriuria with fever; implies pyelonephritis

36
Q

Cystitis

A

Infalmmation of the bladder

37
Q

Urethritis

A

Inflammation of the urethra

38
Q

Pyelonephritis

A

Inflammation of the upper urinary tract and kidney

39
Q

Urosepsis

A

systemic signs of bacterial illness with UTI

40
Q

UTI-nursing care

A
  • 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
Q

signs of UTI

A
  • Incontinence in a toilet-trained child
  • Observance of strong-smelling urine
  • Observance of frequency or urgency of urination
  • Pain on urination
42
Q

Acute glomerulonephritis (AGN)

A
  • 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
Q

Acute glomerulonephritis symptoms

A
  • Oliguria
  • Edema
  • Hypertension
  • Circulatory congestion
  • Hematuria
  • Proteinuria
44
Q

AGN complications

A
  • Hypertensive encephalopathy and cerebral edema
  • Acute cardiac decompensation due to hypervolemia
  • Acute renal failure (ARF)
45
Q

AGN-course of illness

A

10 days to 3 week acute phase, followed by diuresis phase

46
Q

AGN-nursing care

A
  • 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
Q

Assessment of cerebral complications

A

irritability, change in level of consciousness, listlessness, hypertension.

48
Q

Assessment of early renal failure

A

hyperkalemia, hyperphophatemia, uremia, excessive blood urea nitrogen (BUN) and elevated creatinine, oliguria or anuria, metabolic acidosis.

49
Q

Nephrotic syndrome

A

A number of distinct glomerular diseases with increased glomerular permeability which results in massive proteinuria, hypoalbuminemia, hyperlipidemia and edema

50
Q

Types of nephrotic syndromes

A
  • Minimal Change Nephrotic Syndrome (80% of cases in children)
  • Secondary Nephrotic Syndrome (results of AGN)
  • Congenital Nephrotic Syndrome (autosomal recessive genetic disorder)
51
Q

Nephrotic syndrome- nursing care

A
  • 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
Q

Acute renal failure

A

Sudden inability of the kidneys to regulate volume and composition of urine.

  • Oliguria
  • Azotemia
  • Acidosis
  • Diverse electrolyte disturbances
  • Not common in children
53
Q

Enuresis

A

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
Q

Primary enuresis

A

Never achieved continence

55
Q

Secondary enuresis

A

Onset of wetting after having achieved continence

56
Q

Enuresis-causes

A
  • Urinary tract infection that is undetected
  • Genetic predisposition
  • Familial tendency
  • Emotional or behavioral factors
57
Q

Enuresis-nursing care

A
  • 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
Q

Encopresis

A

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
Q

Primary encopresis

A

never achieved continence

60
Q

Secondary encopresis

A

after established fecal continence

61
Q

Encopresis-causes

A
  • 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
Q

Encopresis-nursing care

A
  • 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
Q

Endocrine system-3 components

A
  • 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
Q

Endocrine system

A
  • 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
Q

Major endocrine glands

A
  • Pituitary (anterior and posterior lobes)
  • Thyroid
  • Parathyroid
  • Adrenal
  • Ovaries
  • Testes
  • Islets of Langerhans
66
Q

Minor endocrine glands

A
  • Pineal
  • Thymus
  • Gastrointestinal glands
  • Placenta
67
Q

Assessment of early renal failure

A

hyperkalemia, hyperphophatemia, uremia, excessive blood urea nitrogen (BUN) and elevated creatinine, oliguria or anuria, metabolic acidosis.

Nursing (22 decks)

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