👧🏾- Genitourinary Test Flashcards
S&S of uti in infancy (1-24mo)
Poor feeding, vomiting, failure to gain weight, excessive thirst, frequent urination, straining or screaming when urinating, foul smelling urine, pallor, fever, persistent diaper rash, seizures, dehydration, enlarged kidney or bladder
S&S of uti in neonate
Increased association with malformed or low set ears), poor feeding, vomiting, failure to gain weight, respiratory distress, frequency, screaming on urination, dehydration, poor stream, jaundice, seizures, enlarged kidneys or bladder
S&S of uti in childhood (2-14yrs)
Poor appetite, vomiting, growth failure, excessive thirst, enuresis, incontinence, frequent urination, painful urination, swelling of face, seizures, pallor, fatigue, blood in urine, abdominal pain or back pain, edema, HTN, tetany
Vesicoureteral reflux
Retrograde flow of bladder urine into ureters
Surgical repair if: frequent uti’s, severe anomalies, non-compliant with meds, intolerance to meds
Ureteral reimplants
Phimosis
Narrowing of preputial opening of foreskin
Hydrocele
Fluid in scrotum
Cryptorchidism
Surgery
Failure of testes to descend
Descends between 7-9 months
Surgery- orchiopexy
Exstrophy of bladder
Failure of abdominal wall to fuse & bladder remains outside body
Continually seeps urine
Nephrotic syndrome (NEPHROSIS)
2-7 years old
Hyperalbuminuria= ⬆️protein in urine
Leads to edema and hypovolemia
Hypovolemia= secretion of ADH & Aldosterone
Hyperlipidemia
S&S of nephrosis
Increased weight gain Facial edema Ascites Irritability & fatigue ⬇️ urinary output \+ proteinuria Hypoalbuminemia Hypercholesterolemia Decreased serum protein
Treatment of nephrosis
Corticosteroids (prednisone 2mg/kg)
Diet restrictions (⬇️ Na & ⬆️ protein)
Fluids are ok
IV infusion of albumin
Diuretics
Acute glomerulonephritis
Peak age 6-7yrs
Impetigo
Immune-complex disease that clogs glomeruli
Occurs 1-3wks after strep infection
Causes swelling & exudate in renal capillaries and hematuria
S&S of nephritis
Moderate edema Loss of appetite Oliguria Hematuria Proteinuria Hypertension Irritability & lethargy Azotemia
Nephritis
Patho
⬇️ glomerular filtration, oliguria
⬆️ Na & water= hypervolemia
Causes circulatory overload and edema
Leads to hypertension , cerebral edema & seizures
Cardiac enlargement
Pulmonary congestions
+ ASO titer = previous strep infection
Nephritis
Treatment
Antihypertensives (aprsoline)
Diuretics (lasix)
Anticonvulsants (phenobarb, Dilantin)
FLUID RESTRICTIONS
Low K+ diet (during oliguria)
Monitor serum compliment 3
Daily weight
Hemolytic uremic syndrome
Cause
Acute renal disease
Occurs between 6 months & 5 years
Cause- e.coli 0157:H7
Hemolytic uremic syndrome
Patho
- small glomerular arterioles become swollen & occluded with deposits of platelets & fibrin clots (intravascular coagulation)
- RBC’s are damaged as they attempt to move through the blood vessels
- damaged RBC’s are removed by the spleen
- this leads to decrease in RBC (anemia) & decrease Hct and Hgb, and a decrease in platelets (thrombocytopenia)
- renal damage occurs & produces: proteinuria, hematuria, urinary casts, ⬆️ BUN/creatinine/serum reticulocytes
Hemolytic uremic syndrome
Treatment
Monitor I & O
Blood transfusions
Dialysis (no urine output is common)
Renal failure
Inability of the kidneys to excrete waste material, concentrate urine & conserve electrolytes
Azotemia- nitrogenous waste products in blood
Uremia- toxic amounts of nitrogenous waste products in blood
S&S of acute renal failure
Oliguria (output less than 50cc in 24hrs)
N/V
Edema
Lethargic
Circulatory overload (hypertension, SOB, crackles)
Cardiac Arrhythmia (⬆️ K+)
Azotemia= retention of wastes
Treatment of renal failure
Diet
Fluid & electrolyte replacement
Monitor VS , I&O
Diuretics
Diet-
⬆️ carbs, fat , calcium
⬇️ protein , k, sodium
FLUID RESTRICTIONS
Treat hyperkalemia (kayexalate)
Antihypertensives
Seizure precautions
Hemodialysis
Arterial blood leaves the body & blood is returned via venous supply
4hrs/day 3days/wk
Assess for bruit or thrill - vibration when blood is flowing.
Daily weights before & after treatment
No needle sticks or BP in arm
Transplant procedure
Tissue matching (antigen compatible)
Recipient must be immunosuppressed (prednisone) before & after procedure to treat rejection
S&S of transplant rejection
Fever
Swelling or tenderness over graft area
⬇️ urinary output
⬆️ BP, serum creatinine
Wilms tumor
Diagnosis, treatment
Nephroblastoma
Embryonic tumor of kidney
Peak incidence 2-3 years of age
Diagnosis - X-rays, ct or mri, abdominal ultra sound
Treatment- surgery 24-48hrs , followed by chemo & radiation
S&S of wilms tumor
Usually confined to one side (left) and is firm & non-tender
Hematuria Fatigue & malaise Weight loss Anemia Fever Lymphadenopathy Hypertension (releases renin) Respiratory symptoms
Pre-op care of wilms tumor
DO NOT PALPATE ABDOMEN can cause rupture & metastasis
