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Peds Exam (5900) #3 > GU dysfunction > Flashcards

GU dysfunction Flashcards

1
Q

Common Manifestations of Genitourinary Problems aged birth - 1 month?

A
  • Abnormal voiding patterns (structural or due to urinary tract infection, reflux, obstruction)
  • Poor feeding & failure to gain weight
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2
Q

Common Manifestations of Genitourinary Problems aged 1 month -2 yrs?

A
  • Failure to thrive
  • Fevers
  • Abdominal distention
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3
Q

Common Manifestations of Genitourinary Problems aged 2-14 yrs?

A
  • Delayed toilet training
  • Recurrence of enuresis after toilet training
  • Poor appetite
  • Edema
  • Hypertension
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4
Q

Failure of one or both testes to descend normally through the inguinal canal into the scrotum

A

Cryptorchidism

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5
Q

Cryptorchidism

A

Failure of one or both testes to descend normally through the inguinal canal into the scrotum

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6
Q

Orchiopexy for Cryptorchidism is usually performed at what age?

A

1-2 y/o

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7
Q

Spontaneous descent of the testicle in Cryptorchidism usually occurs at what age?

A

in first year of life

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8
Q

Why would hormone therapy be attempted for Cryptorchidism?

A
  • For bilateral nonpalpable cryptorchidism

- To see if viable testicular tissue is present

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9
Q

Urethral opening of male is located below the glans or underneath the penile shaft

A

Hypospadias

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10
Q

Hypospadias

A

Urethral opening of male is located below the glans or underneath the penile shaft

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11
Q

a ventral curvature of the penis that may accompany hypospadias?

A

chordee

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12
Q

chordee

A

a ventral curvature of the penis that may accompany hypospadias

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13
Q

Surgical repair of a hypospadias is optimally done at what age?

A

6-12 months, no circumcision prior to surgery

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14
Q
  • Short, wide penis with an abnormal curve

- urethra usually opens on the top or side of the penis instead of the tip

A

Epispadius

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15
Q

Epispadius

A
  • Short, wide penis with an abnormal curve

- urethra usually opens on the top or side of the penis instead of the tip

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16
Q

bladder exstrophy

A

rare birth defect where the bladder is inside out and sticks through the abdomen wall

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17
Q

rare birth defect where the bladder is inside out and sticks through the abdomen wall

A

bladder exstrophy

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18
Q

Therapeutic Goals of Epispadias/Exstrophy Management?

A
  • Preserve renal function
  • Attain urinary control
  • Prevent UTIs
  • Preservation of optimum external genitalia with continence and sexual function
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19
Q

Normal antibacterial properties of urinary tract mucosa?

A
  • Acidity of urine
  • Emptying the bladder
  • Peristaltic activity
  • Ureterovesical junction competence
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20
Q

UTI pathogens?

A
  • E. coli
  • Streptococci
  • Staphylococcus saprophysticus
  • Occasionally fungal & parasitic pathogens
  • Common nosocomial infection
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21
Q

Most common cause of UTI?

A

E. coli

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22
Q

UTI: Classification Lower tract

A

Cystitis

Urethritis

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23
Q

UTI: Classification Upper tract

A

Pyelonephritis

Glomerulonephritis

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24
Q

Pediatric patients with significant bacteriuria may have what symptoms?

A

no symptoms or nonspecific symptoms like fatigue, anorexia/poor feeding, changes in bladder habits

25
Q

UTI: Cystitis peak incidence ages?

A

2-6

26
Q

UTI: Cystitis symptoms?

A
  • Frequency, urgency
  • Dysuria
  • Odiferous, cloudy or blood-tinged urine
  • Reoccurrence of enuresis after toilet-training completed
27
Q

Preferred diagnostic study for Cystitis?

A

Clean catch

28
Q

Cystitis: Treatment

A
  • Antibiotics
    • TMP-SMX (Bactrim), Amoxicillin, Nitrofurantoin
  • Increase oral fluid intake
  • Provide comfort measures
29
Q

Common causes of Acute Pyelonephritis?

A

E. coli, Proteus, Klebsiella, Enterobacter

30
Q

Inflammation of the kidney due to infection, usually via ascending urethra route from the bladder?

A

Acute Pyelonephritis

31
Q

Preexisting factors associated with Acute Pyelonephritis?

A
  • Vesicoureteral reflux

- Obstruction or stricture in lower urinary tract

32
Q

Acute Pyelonephritis: Clinical Manifestations?

A
  • Usually abrupt onset
  • N/V, anorexia, fever, chills
  • Nocturia, frequency, urgency, dysuria
  • Suprapubic or low back pain
  • Foul-smelling urine, hematuria, WBCs or pus in urine
33
Q

Acute Pyelonephritis: Treatment & Nursing Care?

A
  • Hospitalization
  • Parenteral (IV) antibiotics
  • Comfort measures
  • Imaging studies (IVP or CT), ultrasound may be done
34
Q

the abnormal flow of urine from the bladder to the upper urinary tract.

A

Vesicoureteral reflux

35
Q

Vesicoureteral reflux

A
  • the abnormal flow of urine from the bladder to the upper urinary tract.
  • often asymptomatic
36
Q

VUR grade(s) that may resolve on its own during early childhood, so will be monitored

A

1-3

37
Q

VUR grade that can lead to permanent kidney damage, scarring, hypertension if not corrected because of increased risk of pyelonephritis

A

4-5

38
Q

an x-ray image of the bladder and urethra taken during voiding. The bladder and urethra are filled with a special dye, called contrast medium, to make the urethra clearly visible.

A

Voiding cystourethrogram (VCUG).

39
Q

Most common type of Glomerulonephritis in children?

A

is Acute Post-streptococcal Glomerulonephritis (APSG)

40
Q

term used to refer to several renal diseases (usually affecting both kidneys), characterized by inflammation of the the glomerulai or small blood vessels in kidneys?

A

Glomerulonephritis

41
Q

Onset of Acute Post-Streptococcal Glomerulonephritis (APSGN)?

A

5-12 days after Group A beta-hemolytic strep infection (strep throat most common)

42
Q

most common APSGN?

A

strep throat

43
Q

APSGN is most common in what age group?

A
  • children 6-7 years old, but can occur at any age

- males > females,

44
Q

Clinical Presentation of APSGN?

A
  • Generalized edema due to decreased glomerular filtration
  • Perioribital and facial edema first noted, especially in a.m.
  • HTN due to increased ECF (mild to moderate)
  • Oliguria
  • Hematuria (COLA-COLORED)
  • Proteinuria
45
Q

APSGN: Management & Nursing Care

A
  • Manage edema
    • Daily weights & abdominal girth
    • Accurate I & O
  • Nutrition
    • No salt added diet, low to moderate protein
  • Monitor BP (may need diuretics)
  • Bedrest is not necessary
  • Antibiotic therapy if NOT treated previously
46
Q

occurs when glomerular membrane becomes permeable to proteins, especially albumin

A

Nephrotic Syndrome

47
Q

Most common type of Nephrotic Syndrome in children?

A

Minimal Change Nephrotic Syndrome (MCNS)

48
Q

Peak incidence of MCNS?

A

2-7 years of age

49
Q

S/S of MCNS?

A
  • Proteinuria (massive)
  • Hypoalbuminemia
  • Edema & weight gain
  • Hyperlipidemia
  • Irritability, fatigue, pallor
  • BP either WNL or slightly increased
50
Q

MCNS: Management & Nursing Care (edema)?

A
  • Daily weights and abdominal girth
  • Accurate I & O
  • Diuretics, albumin helpful in some cases
51
Q

MCNS: Management & Nursing Care (nutrition)?

A
  • Ensure adequate fluid intake
  • void caffeine
  • Moderate protein
  • Sodium restrictions if large amt. of edema
52
Q

Drug of choice of MCNS?

A

Prednisone

53
Q

Potential AE’s of steroids?

A

increased appetite, increased BP, changes in appearance, delayed growth, risk for infection

54
Q

Treatment of choice for MNCS if child is not responding to steroid therapy?

A

Immunosuppressant therapy (Cytoxan)

55
Q

Prerenal causes of AKI usually seen in pediatric patient related to?

A

dehydration

56
Q

Acute kidney injury lab findings?

A
  • elevated blood urea nitrogen and creatinine

- inability of the kidneys to produce sufficient amounts of urine.

57
Q

Potential causes of CRF in pediatric patient:

A
  • Congenital renal & urinary tract malformations
  • VUR associated with recurrent UTIs
  • Chronic pyelonephritis/glomerulonephritis
58
Q

a progressive loss in renal function over a period of months or years

A

Chronic kidney disease (CKD), a.k.chronic renal disease (CRD)

59
Q

Treatment Goals for the Child with CRF, to prevent or reduce?

A
  • Anemia
  • Renal osteodystrophy
  • Infection
  • Growth retardation

Peds Exam (5900) #3 (10 decks)

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