GU - PP Flashcards
cryptorchidism is a fancy word for
undescended testes
when do we assess for cryptorchidism
during our newborn assessment
when would the testes spontaneously descend into scrotal sack
3 months without intervention
why would we need to ensure testes descend
increased risk for testicular cancer later in life
increased temperature - affect on healthy sperm
it is rare for testes, once descended, to revert back t or f
true - very uncommon
dx for cryptorchidism
ultra sound - CT scan - location purposes
trt for cryptorchidism
orchiopexy
what happens in an orchiopexy
stitch in abdomen/testes - pull testes into scrotum
post-op stitches in abdomen/scrotum
is an orchiopexy an outpatient procedure
yes
when is an orchiopexy performed (age)
usually between 6-24 months
true absence of testes is rare t or f
true - would be caused by testosterone deficiency
what population is cryptorchidism commonly seen in?
preemies - just hasn’t happened yet
post op care of cryptorchidism/orchiopexy
wound care protect area from injury/infection change diaper often antibiotic ointment pain control no tub baths (2-3 days); give sponge baths double diaper no hip placement holding (positional)
hypospadias is what type of defect?
congenital defect
manifestation of hypospadias
malformation of urethra - below normal placement (ventral side of penal shaft)
altered urine stream - down and straight
chordee
increased risk for this with hypospadias
congenital (father or sibling affected?)
inguinal hernia
cause of hypospadias
unknown
when does hypospadias occur
9-12 weeks of development
what is chordee?
curvature of the penis
what can happen with chordee?
difficulty with erection
correction of chordee
surgery to lengthen the urethra
done at 6-12 months (prior to toilet training/body image)
should we circumcise a child presenting with chordee
no - use foreskin to help lengthen penis/making urethra
post surgery care/trt for chordee surgery
catheter left in urethra so urine doesn’t hit incision area (stitched to head of penis)
double diaper to protect from injury to area
no straddling
no rough housing
no tub baths
when will catheter be removed post chordee surgery
7-10 days post-op
when will we dx/identify hypospadias
newborn assessment
assessing stream/dribbling
family hx
what happens in bladder extrophy
gastroschisis (opening) - protrusion of bladder through the abdominal wall
ureters might not be connected
manifestations of bladder extrophy
may not get full use of bladder
penis size is shorter in males
may not have vaginal opening or narrowing in girls
may never get full fxn of bladder/lifetime incontinence
treatment for bladder extrophy
many surgeries - first within 1st 48 hours
what interventions are necessary in bladder extrophy if you don’t get full use of the bladder
urostomy
urinary diversion
pre-op care for bladder extrophy surgery
cover exposed organs (protection)
can bladder extrophy be detected by ultrasound
yes- may be present on delivery as well
those with bladder extrophy are at an increased risk for
*cancer (bladder, colon)
urine prolapse in women
the most common kidney tumor of childhood
wilms tumor
dx of wilms tumor
CT/MRI/US of abdomen
images to check for metastasis (chest CT)
labs
manifestation of wilms tumor
swelling in abdomen
standard treatment for wilms tumor
*surgery and chemo
chemo trt for wilms tumor starts/lasts for?
always after surgery
lasting 6-15 months
sometimes before surgery
will pt. with wilms tumor receive radiation
sometimes for shrinking tumor - but standard is surgery and chemo
wilms tumor has one of the highest survival rates among childhood cancers, t or f?
true
nursing care for wilms tumor
**DO NOT PALPATE TUMOR
KEEP TUMOR ENCAPSALATED - BEST THING FOR SURVIVAL
Monitor BP r/t renal artery compression
preschoolers have difficulty understanding chemotherapy trt since it makes them feel so sick, t or f
true
single kidney concerns
**NO CONTACT SPORTS
trauma to the remaining kidney
wear bracelet to identify pt. as having a single kidney
peak and troth for therapeutic range (medication)
