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PRNU 232 > Lecture 6 Genitourinary > Flashcards

Lecture 6 Genitourinary Flashcards

1
Q

primary role of kidneys

A

maintain composition of body fluids

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2
Q

secondary role of kidneys

A

erythropoietin stimulating factors
renin to reduce blood volume
activate vitamin D
acid-base balance

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3
Q

pediatric kidney anatomy

A
  • take up more room in the abdomen
  • short urethra
  • slower blood flow through kidneys
  • less efficient
  • small bladder volume
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4
Q

when does renal system reach maturity?

A

2 years

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5
Q

pediatric GU history

A
  • prenatal history
  • family history
  • age of toilet training
  • bed wetting (primary or secondary)
  • recent infectious diseases
  • medications
  • unusual elimination patterns including defecation
  • sexual or menstrual history if applicable
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6
Q

pediatric GU assessment

A
  • consistent weights
  • abdominal and extremity girth measurements for edema
  • BP and cardiac exam
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7
Q

collecting urine for analysis

A

clean catch
urine bag
catheterization
suprapubic needle aspiration

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8
Q

urine labs

A

urinalysis
urine culture and sensitivities
BUN and creatinine

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9
Q

Voiding cystourethrogram

A
  • radiopaque dye infused into bladder with catheter
  • watch bladder fill and empty under fluoroscopy
  • will se retrograde flow of urine up ureters with bladder contraction if vesicoureteral reflux is presennt
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10
Q

normal urinalysis

A

pH 5-9
specific gravity 1.001 to 1.035
protein <20
urobilinogen <1 mg
clear

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11
Q

abnormal urinalysis findings

A

glucose
ketones
WBCs
RBCs
nitrites
casts

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12
Q

hypospadias

A

urethral meatus on ventral surface of penis

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13
Q

epispadias

A

urethral meatus on dorsal surface of penis

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14
Q

how are hypospadias and epispadias treated

A

no circumcision prior to surgery
surgery at 6-12 months

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15
Q

post-op management of hypo/epispadias surgery

A

no rough housing for 4 weeks
foley catheter care
no tub baths until post-op check and dressing removed

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16
Q

bladder exstrophy

A

wide pubic symphysis
epispadias in males
may be diagnosed on prenatal ultrasound

17
Q

cause of vesicoureteral reflux

A

can be congenital or secondary to neurogenic bladder or obstruction

18
Q

complications of vesicoureteral reflux

A

pyelonephritis
dilation of ureters
renal scarring
HTN

19
Q

obstructive uropathy

A

obstruction in any part of urinary tract

20
Q

complications from obstructive uropathy

A

hydronephrosis (kidney dilation)
recurrent UTI
renal insufficiency
renal damage

21
Q

post-strep glomerulonephritis

A

complication following group A strep infection, usually around 10 days after onset

immune response to strep causes inflammation of glomeruli

22
Q

clinical manifestations of PSGN

A

dark urine
proteinuria
fever
oliguria
abdominal pain
headache
vomiting
edema
hypertension

23
Q

PSGN nursing interventions

A

usual interventions for fluid excess
limit salt, diuretics, strict I/Os, daily weight, abdominal girth, BP

24
Q

isotonic dehydration

A

overall loss of volume, both electrolytes and water
most common type of dehydration

25
Q

why are children at risk for dehydration?

A
  • kidneys not good at concentrating urine
  • higher RR and metabolic rate = more waste to break down and excrete
26
Q

pediatric hydration assessment

A
  • intake and output - weigh diapers
  • patient weight
  • fontanelles
  • mucus membranes
  • tear production
  • turgor and cap refill
27
Q

calculating daily fluid needs for children

A
  • 100 ml/kg for first 10 kg
  • 50 ml/kg for next 10 kg
  • 20 ml/kg for remaining body weight
28
Q

normal urine output for children

A
  • babies - 2 ml/kg/hr
  • toddlers - 1.5 ml/kg/hr
  • children - 1 ml/kg/hr
29
Q

what is nephrotic syndrome?

A
  • impaired glomerular permeability
  • protein and large particles can filter into the urine
  • occurs due to many different kidney diseases, describes a combination of clinical findings
30
Q

features of nephrotic syndrome

A
  • hyponatremia, hypoalbuminemia, proteinuria (it’s all getting peed out)
  • hyperlipidemia
  • renal vein thrombosis
  • orbital edema
  • thromboembolism
  • infection r/t loss of immunoglobulins in urine
  • coagulability r/t loss of antithrombin in urine
31
Q

signs and symptoms of nephrotic syndrome

A

weight gain and edema - fluid retention
foamy urine from proteins
fatigue
loss of appetite

32
Q

diagnosing nephrotic syndrome

A

24 hour urine
proteinuria >3g
renal biopsy for children >8 years
MRI for glomerular scarring

33
Q

nursing interventions for nephrotic syndrome

A

Strict I/Os
urine testing
daily weights
low salt diet
rest
medication administration

PRNU 232 (7 decks)

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