Module 12: Care of a Child with Genitourinary System Condition Flashcards
1
Q
urine for culture and sensitivity
A
- culture: see what bacteria grow on it, then check its sensitivity
- sensitivity: what drugs will kill this bacteria
2
Q
routine and microscopic urinalysis
A
- assess for protein levels
- bacteria
- blood
- creatine
3
Q
intravenous pyelogram
A
- if something is wrong with kidneys or ureters, injected with dye and X-ray taken to see how blood is flowing through the urinary system
4
Q
hypospadias/epispadias
A
- urinary meatus is not at the end of penis
- hypo= under; epi= on top
- various degrees
- causes: genetics, low levels of testosterone, HCG in pregnancy advanced maternal age
- corrected for cosmetic reasons, infertility, urination
- treatment:
- > if meatus near tip no treatment
- > surgery done to:
- -allow patient to urinate standing
- -correct chordee
- -preserve fertility
- -cosmetically acceptable appearance
- -repair done between 6-12 months
- -often a day surgery
- -use foreskin for repair
- Prognosis
- > depends on severity of the hypo/epispadias
- > usually normal urinary and reproductive functioning after repair
- > complications: bleeding, stenosis, UTI post-operatively
5
Q
hydrocele
A
- must of the time absorbs by 1 year of age
- painless swelling of one side of scrotum
- decreases lying, increases with crying
- diagnosis: transillumination
- surgery - hydrocolectomy- removal of fluid and closure of canal
6
Q
cryptorchidism
A
- undescended testicles; more common with right testis
- bilateral in 10% of cases
- early detection important
- ultrasound then laparoscopy done to see where it (they) are
- kidney function also tested since same cells form the kidneys
- 80% of cases - testes migrate into scrotum by age 1 without treatment
- the abdomen is too warm nd will affect development of testis - sterility later
- orchiopexy to bring them into scrotum
- bilateral undescended may affect fertility even with surgery
7
Q
urinary tract infections
A
- more common in females
- normal urine is acidic
- most caused by E. coli
- alkaline urine favours pathogens
- arthritis
- cystitis
- bacteriuria
- ureteritis
- pyelonephritis
- S&S depend on the age of the child, fever, reduced urine output, not eating, redness or irritation around urethral opening
- Treatment
- > infants under 1 year old are usually hospitalized for IV antimicrobials
- > older children are treated at hime with oral antimicrobials
- > parent teaching stresses the need for proper amounts of fluid to maintain sterility and flushing of the bladder
- > interventions to prevent UTI
– cleanse perineum with each diaper change- -wipe perinium front to back
– avoid bubble baths
– have child urinate immediately after a bath
– use cotton underwear
–use loose fitting pants
–offer adequate fluid intake
-
- -wipe perinium front to back
8
Q
nephrotic syndrome
A
- referee to a number of different type son kidney conditions
- increase in glomerular permeability to proteins (albumin) which leads to hypoalbuminemia
- more common in boys; occurs age 2-7
- S&S: edema occurs slowly around eyes and ankles and alter becomes generalized edema
- shifts with the position of the child during sleep
- weight gain
- pale, irritable, poor appetite
- BP usually normal
- urine exam reveals massive albumin
- Treatment
- steroids, prognosis is good in steroid- repsonsive pt, minimize edelman, prevent infection, high protein diet, duiretics are not effective, avoid adding salt
- Nursing care
- supportive care to parents and child
- parent to keep daily record of child’s weight, urinary protein levels and medications
- no vaccinations or immunizations should be administer while the disease is active or during immunosuppressive therapy
9
Q
hemolytic uremic syndrome
A
- rare kidney disorder marked by renal failure
- in children most often follows bloody diarrhea from an infection with E. Coli
- toxin released in colon damages epithelial lining of vessels -targets the kidneys
- micro emboli- how would this impact the kidneys?
Nursing care is supportive
10
Q
Wilms tumor (nephroblastoma)
A
- thought to be genetic basis
- most discovered before age 3 years
- one of the most common malignancies of early life
- few or no symptoms during the early stages
Most common symptoms
1. abdominal pain
2. hematuria
3. hypertension
4. abdominal mass - Iv pyelogram reveals a growth, tutor compresses kidney tissue usually encapsulated
- until the tutor has even surgically removed abdominal palpation but not be performed
- a sign above the bed and a notation on the chart must clearly state no abdominal palpation
- Treatment
- combination of surgery, radiation, and chemo
- affected kidney and tumor removed as soon as possible
- Nursing care
- preoperative
- avoid abdominal examination by caregivers
- routine postoperative care
11
Q
inguinal hernia
A
- protrusion of bowel in the inguinal canal
- more common in boys, 9:1
- will see lump on one side of groin, may be bilateral
- painless- if pain = emergency - bowel strangulation
- surgery usually by age 1
- herniorraphy
12
Q
testicular torsion
A
- testis is strangled when spermatic cord twists
- can destroy a testis in 4-6 hours
- emergency situation
- occurs most often in adolescent
- often during physical acitivity
- common cause is lack of scrotal support
- severe pain, redness, swelling unilateral, lower abdominal pain, nausea, and vomiting
- need immediate surgery to restore blood supply
- if permantely damage, will be removed and prosthetic inserted
13
Q
testicular tumors
A
- boys less than 4 yrs olds with peak around 2 yrs of age
- S&S painless scrotal swelling, hard mass palpable in scrotum
14
Q
Phimosis
A
- narrowing of the foreskin
- normal in newborns usually disappears by age 3
- urine flow may be affected
- circumcision may be indicated
- only a problem is child cannot void properly
15
Q
Labial adhesion
A
- labia minora and majora will not separate
