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Child Health Care > GU > Flashcards

GU Flashcards

1
Q

Bladder exstrophy Definition

A

Posterior bladder wall
extrudes through lower
abdominal wall

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2
Q

Bladder exstrophy Sx

A

-Bladder mucosa appears as mass of bright-red tissue
-urine leaks from ureters onto
the skin

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3
Q

Bladder exstrophy Tx

A
  • bladder tissue is covered w/ plastic until surgery
  • closure within 24-48 hours after birth
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4
Q

Epispadias Definition

A
  • Males: meatal opening located on dorsal surface of penile shaft
    -Females: cleft of ventral urethra that extends to bladder neck
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5
Q

Hypospadias Definition

A

Urethral meatus located anywhere along the course of urethra on ventral surface of penile shaft

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6
Q

Hypospadias Post-op care

A

-No tub baths until stent/catheter removed
-Double diapering
-No ride-on toys, no hip straddle position x 2 weeks
-Infection sx
-ABX if ordered
-Hydration status
-Blood in urine is normal at first but only pink tinged

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7
Q

Obstructive Uropathy Definition

A

Structural/functional abnormalities of urinary system
that interfere with urine flow

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8
Q

Obstructive Uropathy Complications

A

-Pressure by urine backup causes hydronephrosis
-Cessation of glomerular filtration
-Metabolic acidosis
-Impairment of kidney’s ability to concentrate urine
-Urinary stasis
-Restriction of urinary outflow

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9
Q

Obstructive Uropathy Tx

A

-Surgical correction

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10
Q

Prune Belly Syndrome Defintion

A

-AKA Eagle-Barrett syndrome
-Failure of ABD
musculature to develop

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11
Q

Prune Belly Syndrome Sx

A

-Skin covering ABD wall is thin and resembles a wrinkled prune
- urinary tract anomalies
-poor ureteral peristalsis
-enlarged bladder
-increased UTI

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12
Q

Prune Belly Syndrome Tx

A

-ABD wall reconstruction and correction of GU defects

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13
Q

Enuresis Definition

A

-Repeated involuntary voiding by a child old enough to have expected bladder control
-Primary: never had a dry night
-Secondary: was dry for 6 months then started wetting self

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14
Q

Enuresis Tx

A

-Fluid restriction
-Bladder training
-Enuresis alarms (last resort)
-Double-voiding
-Medications (DDAVP, TCAs, Oxybutynin Chloride)
-Meds SE:

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15
Q

UTI Definition

A

-Bacterial, viral or fungal origin
-Upper UTI (Pyelonephritis): ureters, renal pelvis, renal
parenchyma
-Lower UTI (Cystitis): Urethra and bladder

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16
Q

UTI Causes

A

-Urinary stasis
-Poor hygiene
-Inadequate cleansing
-Constipation
-Sexual activity
-Vesicoureteral reflux

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17
Q

UTI Sx

A

-Infants: irritability, unexplained fever, hypothermia, failure to thrive, poor feeding, vomiting
and diarrhea
-Older children: mimic more “classic” sx (cloudy, painful, bloody urine)

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18
Q

UTI Tx

A

-Fluids
-ABX (Bactrim (SJS), then cephalosporin)
-Follow up cultures
-Dx: midstream, clean-catch urine culture > 100,000 colony forming units (cfu) of a single bacteria or > 50,000 cfu of single bacteria cultures from sterile specimen
Dx: Radiologic studies
-Education: no bubble bath, cotton underwear, sexual activity, diet, fluids, wipe right

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19
Q

UTI increases kidney dmg if:

A

-UTI in infant < 1 year of age
-Delay in Dx and effective ABX Tx
-Anatomic obstruction or nerve supply interruption
-Recurrent episodes of upper UT

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20
Q

Phimosis Definition

A
  • Foreskin over glans penis and cannot be retracted
  • Normal in uncircumcised infants and young males
21
Q

Phimosis Tx

A

-Circumcision
-Betamethasone Cream BID for 4-8 weeks (steroids reduce swelling/inflammation)

22
Q

Cryptorchidism Definition

A
  • One or both testes fail to descend through inguinal canal into scrotum
23
Q

Cryptorchidism Complications

A

-infertility
-malignancy

24
Q

Cryptorchidism Tx

A
  • orchiopexy if testes don’t descend on its own
25
Q

Inguinal Hernia and Hydrocele Definition

A
  • Inguinal hernia: painless swelling of variable size
    that occurs when ABD tissue extends into canal
  • Hydrocele: Fluid filled mass in the scrotum
26
Q

Inguinal Hernia and Hydrocele Tx

A

-outpatient surgery

27
Q

Testicular Torsion Definition

A
  • testis suddenly rotates on its spermatic cord, cutting off its blood supply leading to
    vascular engorgement and ischemia
28
Q

Testicular Torsion Sx

A

-Severe pain in scrotum
-erythema in scrotum
-testes are tender on palpation
-cremasteric reflex is absent

29
Q

Testicular Torsion Tx

A

-Emergent surgery
-When torsion is reduced within 6hrs, 90% of saving testis

30
Q

Nephrotic Syndrome Definition

A

Alteration in kidney function
secondary to increased
glomerular basement
membrane permeability to
plasma protein

31
Q

Nephrotic Syndrome Sx

A
  • Edema over several weeks
    -Snug fit of clothing/shoes
    -Pallor
    -HTN
    -Irritability
32
Q

Nephrotic Syndrome Labs

A

-Urine: Proteinuria, RBCs
-Blood: GFR- normal to high, Hypoalbuminemia, Potential hyponatremia, Elevated Hgb, Hct, platelets

33
Q

Nephrotic Syndrome Tx

A

-albumin
-prednisone (steroid)
-diuretics

34
Q

Nephrotic Syndrome Care

A
  • skin breakdown
    -ABD girth
    -nutrition (limit NaCl)
    -Manual BP
35
Q

Acute Postinfectious
Glomerulonephritis (APIGN) Definition

A

-inflammation of glomeruli of kidneys from strep

36
Q

Acute Postinfectious
Glomerulonephritis (APIGN) Sx

A

-Edema
-Oliguria
-Flank/Mid-abdominal pain
-Irritability
-Malaise
-Fever

37
Q

Hemolytic-uremic Syndrome (HUS) Definition

A

-caused by E.coli

38
Q

Hemolytic-uremic Syndrome (HUS) Sx

A

-Hemolytic Anemia
-Thrombocytopenia
-Acute Renal Failure

39
Q

Hemolytic-uremic Syndrome (HUS) Tx

A

-Fluid Restrictions
-High-calorie, high-carb
-Low protein, Na, K and P
-Transfusions
-Medications
-May require hemo or peritoneal dialysis

40
Q

Polycystic Kidney Disease Definition

A

-Cellular hyperplasia of
collecting ducts causes dilation
of ducts.
-Fluid secreted into ducts
enables cyst sacs to form
-Cysts replace kidney’s mass
and reduce kidney function

41
Q

Polycystic Kidney Disease Sx

A

-Potter facies
-HTN
-Osteodystrophy

42
Q

Polycystic Kidney Disease Tx

A

-Supportive care
-Diuretics

43
Q

Acute Renal Failure Definition

A

Sudden loss of adequate renal function in which kidneys are unable to clear metabolic wastes and to regulate ECF volume, sodium balance, and acid-base homeostasis

44
Q

Acute Renal Failure Sx

A

-Healthy child becomes ill with nonspecific symptoms such
as N/V, lethargy, edema, hematuria
-Usually due to electrolyte imbalances

45
Q

Acute Renal Failure Complications

A

-Hyperkalemia
-Uremia
-Azotemia
-Treat underlying cause

46
Q

Chronic Renal Failure Definition

A

-Progressive, irreversible reduction in kidney function

47
Q

Chronic Renal Failure Sx

A
  • Minimal renal function
    -Uremic Syndrome
    -Anemia
    -Abnormal blood values
    -Polyuria
    -Pallor
    -Headache
    -Nausea
    -Decreased mental alertness
48
Q

Chronic Renal Failure Tx

A

-Irreversible but course of
disease is variable
-Diet
-Meds
-Renal Replacement Therapy
(Dialysis)

49
Q

Peritoneal Dialysis

A

-Dialysate instilled via catheter
-Remains in peritoneal cavity for dwell time
-Emptied and exchanged with
fresh dialysate (room temp)
-May preserve kidney
function
-Risks of infection

Child Health Care (7 decks)

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