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PEDS > lecture 6 [adolescent + renal] > Flashcards

lecture 6 [adolescent + renal] Flashcards

1
Q

what kind of changes are to be expected in the postpubescent period?

A
  • complete skeletal growth
  • well-established reproductive functions
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2
Q

ages

early adolescence

A

11-14

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3
Q

ages

middle adolescence

A

15-17

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4
Q

ages

late adolescence

A

18-20

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5
Q

which gland is responsible for the development of secondary sex characteristics?

A

anterior pituitary gland

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6
Q

which part of the brain stimulates the anterior pituitary gland?

A

hypothalamus

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7
Q

what stage of Erikson’s are adolescents in?

A

group identity vs. alienation

Stage 5

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8
Q

what is the nurse’s role regarding parents & adolescents?

A

facilitator between their discussions without taking any sides

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9
Q

what stage of Piaget’s developmental thought processes are adolescents in?

A

formal operational (abstract & hypothetical thinking)

stage 4

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10
Q

what are the characteristics of thought processes that adolescents have developed?

(4)

A
  • mental manipulation of 2 or more variables simultaneously
  • hypothetical thinking
  • scientific & formal logic
  • higher ability to “stand in someone’s shoes”
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11
Q

how does an adolescent’s relationship with their parents change?

A

mutual affection & equality

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12
Q

adolescents begin to develop sexual orientation & identification during this stage

A

true

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13
Q

what are the nursing implications for an adolescent’s developing sexuality?

A

present sex-ed in a straightforward manner

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14
Q

caloric needs & protein requirements are higher at this stage than others

A

true

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15
Q

what is the most common nutritional disturbance & challenging health problem of adolescents?

A

obesity

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16
Q

what is the likelihood of obese adolescents to become obese adults?

A

70-80%

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17
Q

most adolescents who have disturbed sleeping patterns tend to describe themselves negatively

A

true

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18
Q

what are common sleep disturbances among adolescents?

(4)

A
  • difficulty waking
  • sleepiness during the day
  • frequent periods of wakefulness in the middle of the night
  • difficulty going to sleep
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19
Q

at what age do girls start getting the HPV vaccine?

A

9 yrs old

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20
Q

how many weeks apart are Varicella doses for children younger than 13 yrs old?

A

3 months

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21
Q

how many weeks apart are Varicella doses for children older than 13 yrs old?

A

4 weeks

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22
Q

what are the various external defects of the genitourinary system among adolescents?

(9)

A
  • inguinal hernia
  • hydrocele
  • phimosis
  • hypospadias
  • chordee
  • epispadias
  • cryptorchidism
  • bladder exstrophy
  • ambiguous genitalia
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23
Q

when does surgery happen for GU defects?

A

before preschool

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24
Q

nurses need to be conscious of how children view genital surgery–it may be a “punishment” & become obsessed with what is “normal”

A

true

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25
Q

definition

inguinal hernia

A

protrusion of ABD contents into scrotum

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26
Q

definition

phimosis

A

narrowed opening of foreskin

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27
Q

definition

chordee

A

ventral curvature

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28
Q

definition

cryptorchidism

A

undscended testes

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29
Q

definition

bladder exstrophy

A

bladder develops outside of exterior ABD wall

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30
Q

what is the pathophysiology of obstructive uropathy?

A

hydronephrosis causing distal nephron damage leading to urine concentration

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31
Q

what is the nursing care for obstructive uropathy?

(4)

A
  • potential discharge w/ equipment (urostomy, kidney drains)
  • present options for dialysis or transplant
  • increase fluid
  • monitor for sediments
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32
Q

what are some GU dysfunctions commonly seen among children?

(9)

A
  • UTI
  • vesicoureteral reflux
  • obstructive uropathy
  • nephrotic syndrome
  • acute glomerulonephritis
  • hemolytic uremic syndrome
  • Wilms Tumor
  • AKI
  • CKD
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33
Q

what are the types of UTI?

(2)

A
  • cystitis (bladder)
  • pyelonephritis (kidney)
34
Q

what are the risk factors for UTI?

(5)

A
  • uncircumcised males under 3 months
  • short urethera in females
  • urine stasis
  • malformation of another system (i.e. low-set ears or ear tags)
  • renal reflux or malformation
35
Q

why are ear malformations considered a risk factor for UTI?

A

the ears & kidneys were developing simultaneously in-utero

36
Q

what is the nursing care for UTI?

A
  • increase fluid intake (for flushing)
  • cranberry juice (sugar-free)
37
Q

what are the s/s of UTI?

A
  • decreased appetite
  • back pain
  • polyuria
  • polydipsia
  • pain w/ voiding
  • hematuria
  • fatigue
  • abd pain
38
Q

pathophysiology of vesicoureteral reflux

A

cytitis moves to pyelonephritis

39
Q

what are the s/s of vesicoureteral reflux?

(4)

A
  • residual urine in ureters
  • high fevers
  • emesis
  • chills
40
Q

what are the diagnostic test for vesicoureteral reflux?

(2)

A
  • cytoscopy
  • voiding cystourethrogram
41
Q

what is the nursing care for vesicoureteral reflux?

(3)

A
  • prevent bacteria travelling up to kidneys from bladder
  • low-dose ABX
  • cultures every 2-3 months
42
Q

what is the pathophysiology of nephrotic syndrome?

A

increasing permeability of basement membrane in kidneys leading to albumin leaks & accumulation of fluid in interstitial spaces

43
Q

what is the etiology of nephrotic syndrome?

A
  • proteinuria
  • hypoalbuminemia
  • nephrosis
  • glomerular damage
  • autosomal recessive
44
Q

what are the manifestations of nephrotic syndrome?

(7)

A
  • weight gain
  • edema
  • ascites
  • poor appetite
  • HTN
  • tired
  • proteinuria
45
Q

what is the treatment for nephrotic syndrome?

A
  • low Na+ diet
  • severe fluid restriction
  • diuretics (due to edema)
  • 25% albumin
  • steroids
46
Q

what is the goal for treating nephrotic syndrome?

A
  • reduce excretion of urinary protein
  • reduce fluid retention in tissues
  • prevent infection
47
Q

which conditions does glomerulonephritis usually precede?

A
  • pneumococcal infections
  • streptococcal infections
48
Q

how long is the latent period for glomerulonephritis preceding certain viral & bacterial infections?

A

10 days

49
Q

what is the nursing care for glumerulonephritis with BP WNL?

A

teach home management

50
Q

what is the nursing care glomerulonephritis in the hospital?

A
  • strict Na+ restriction
  • daily wt
  • seizure precautions (indicated for pt w/ edema & hematuria)
51
Q

what is an indication for improving glomerulonephritis?

A

increasing C3 levels

52
Q

what is the role of C3 factors in the immune system?

A

activates the complement system in which antibodies are more effective in eliminating microbes

53
Q

what is the pathophysiology of hemolytic uremic syndrome?

A

endothelial lining of glomerular arterioles swell & are occluded due to plt & clot deposits causing damage to RBCs and their elimination by the spleen

54
Q

what is the triad for HUS?

A
  • anemia
  • thrombocytopenia
  • renal failure
55
Q

what are the manifestations of HUS?

A
  • acuired hemolytic anemia
  • thrombocytopenia
  • renal injury
  • CNS changes
  • E. coli infection
56
Q

what is the treatment for HUS?

(3)

A
  • hemodialysis
  • FFP (fresh frozen plasma)
  • plasmapheresis
57
Q

complications of HUS

(3)

A
  • chronic renal failure
  • HTN
  • CNS disorders
58
Q

another name for Wilms Tumor

A

nephroblastoma

59
Q

Wilms tumor typically affects the left kidney

A

true

60
Q

Wilms tumor predominantly affects black children

A

true

61
Q

manifestations of Wilms tumor

A
  • aniridia
  • hemihypertrophy
  • overgrowth syndrome (Beckwith-Wiedemann)
62
Q

diagnostic procedures for Wilms tumor

A
  • radiographic studies (x-ray)
  • ABD U/S
  • hematologic & biochem studies
  • UA
63
Q

why should nurses not palpate the protrusion in Wilms tumor?

A

to avoid rupturing the tumor

64
Q

what is the treatment for Wilms tumor?

A

surgical removal of tumor, affected kidney, & adjacent adrenal gland

65
Q

what is the etiology of AKI?

A
  • decreased perfusion
  • kidney disease
66
Q

what are the implications for AKI?

A
  • azotemia
  • uremia
  • inability to excrete waste, concentrate urine, & conserve electrolytes
67
Q

definition

azotemia

A

accumulation of nitrogenous waste in blood

68
Q

definition

uremia

A

retention of nitrogenous products in the blood

69
Q

diagnostic results for AKI

A
  • elevated BUN
  • reduced GFR
  • elevated creatinine
70
Q

manifestations for AKI

A
  • oliguria
  • diuresis
71
Q

what type of precautions need to be considered for AKI?

A
  • seizure
  • cardiac failure
72
Q

treatment for oliguric AKI

A

avoid Na+, Cl, K+

73
Q

treatment for hyperkalemic AKI

A

Kayexalate

74
Q

treatment for hypertensive AKI

A
  • anti-HTN
  • limit fluids
  • limit salt
75
Q

treatment for anemic AKI

A

PRBC

if Hgb is < 6g/dL

76
Q

pathophysiology of chronic kidney injury

A

damaged nephrons leading to inability to maintain fluid & electrolyte balance

77
Q

common s/s of CKI

A
  • fatigue
  • pallor
  • HA
  • HTN
  • nausea
  • cramps
  • CNS changes
78
Q

diet management for CKD

A
  • high carbs
  • high Ca
  • limit fresh produce & fruits
  • low protein
  • low K+, Na+, P
  • unrestricted fat intake
79
Q

supplements for CKD

(5)

A
  • folate
  • iron
  • water-soluble vitamins (Vit B & C)
  • Vit D
  • phosphorus binding agents (Ca carbonate & aluminum hydroxide)
80
Q

complications of CKD

A
  • anemia
  • HTN
  • infection
81
Q

which condition is dialysis only indicated for?

A

ESRD

PEDS (11 decks)

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