objective 10.6

Question 1

what is an expected urine output for a child?

Answer 1

1 to 2mL/kg/hr

Question 2

what is the expected urine output for older children?

Answer 2

30mL/hr

Question 3

what is the bladder capacity at birth?

Answer 3

50mL

Question 4

what is the bladder capacity of an adult?

Answer 4

700mL

Question 5

 More common in girls than boys
◦ Shorter urethra, near the rectum
◦ Close fitting nylon underwear
◦ Bubble baths
◦ Retention of urine
◦ Vaginitis
◦ Toilet training (improper cleaning)
 Most are caused by Escherichia coli

Answer 5

urinary tract infection

Question 6

what are interventions to prevent UTI?

Answer 6

• Cleanse perineum with each diaper change
• Wipe from front to back
• Avoid bubble baths
• Have child urinate right after a bath
• Encourage child to empty bladder frequently throughout the
  day
• Use white, cotton underwear
• Use loose fitting pants
• Offer adequate fluid intake

Question 7

infection of the urethra

Answer 7

urethritis

Question 8

inflammation of the bladder

Answer 8

cystitis

Question 9

bacteria in the urine

Answer 9

bacteriuria

Question 10

infection of the kidney and the renal pelvis

Answer 10

pyelonephritis

Question 11

infection of the ureters

Answer 11

ureteritis

Question 12

backward flow of urine from the bladder to the kidneys with voiding

Answer 12

vesicoureteral reflux

Question 13

what are the S&S of a uti in infants?

Answer 13

fever, frequent urination, foul-smelling urine, persistent
diaper rash, vomiting & chills

Question 14

what are the S&S of a uti in older children?

Answer 14

urinary frequency, pain during micturition, onset of
bed-wetting in a previously “dry” child, and abdominal pain may
be present

Question 15

what is a treatment of a uti?

Answer 15

 Infants who are less than 2-3 months of age, toxic looking or
complicated UTI’s are hospitalized.
 under 1 year are usually hospitalized and treated with IV antibiotics
 Most children are treated at home with oral antibiotics
 Parent teaching stresses the need for proper amounts of fluid to
maintain sterility and flushing of the bladder

Question 16

 Tight foreskin, classified as physiological or pathological, prevents
retraction back over glans
 Prevents foreskin from being retracted over penis (normal in newborns
and usually disappears by age 3)
 Tx: topical Steroids or circumcision

Answer 16

phimosis

Question 17

Forcible retraction of a tight foreskin is avoided because it can lead to
 Foreskin cannot be returned to its normal position
 Swelling and impaired circulation caused by constriction
 Can obstruct stream of urine
 Immediate attention needed

Answer 17

paraphimosis

Question 18

a congenital defect in which the urinary meatus is located
on the lower portion of the shaft
* may be accompanied by chordee

Answer 18

hypospadias

Question 19

urinary meatus is on the upper surface of the penis

Answer 19

epispadias

Question 20

what is the treatment of hypospadias and epispadias?

Answer 20

 mild cases surgery is not indicated
 Surgery may be indicated if child will not be able to stand to
void or if it may cause psychological issues or difficulties in
future sexual relationships
 Surgery is usually performed bet 12-18 months
 No circumcision: foreskin can be useful in the repair

Question 21

A number of different types of kidney conditions that
are distinguished by the presence of marked
amounts of protein in the urine (classic symptom),
edema, hypoalbuminemia and high cholesterol

Answer 21

nephrotic syndrome

Question 22

what are the symptoms of nephrotic syndrome?

Answer 22

Proteinuria & Edema (first
around eyes, ankles then
generalized),
Wt. Gain
Abd may be distended (Ascites)
Pale, irritable, and listless, poor
appetite

Question 23

what is the treatment of nephrotic syndrome?

Answer 23

Steroid treatment (oral prednisone)
Diuretics sometimes used if edema is severe
Diet- avoid salt, no fluid restriction unless massive edema
Supportive care
Daily Wt., urinary protein levels and medications
Positioning
No vaccinations or immunizations are given during the acute phase of the
illness especially while on steroid treatment
I & O

Question 24

 Testes fail to lower in the scrotum
* Unilateral form is more common
 Testes are warmer in abdomen, sperm cells
begin to deteriorate
* If both testes involved, sterility can result
* Inguinal hernia often accompanies this
condition
 Secondary sex characteristics are not
affected because the testes continue to
secrete hormones directly into the
bloodstream

Answer 24

cryptorchidism

Question 25

what is the treatment/nursing care of cryptorchidism?

Answer 25

 Orchidopexy improves the condition; fertility rate among these
patients may be reduced
 Scrotal support
 Prevent contamination of suture line
 Psychological and emotional support
 Surgery on “private parts” can be embarrassing

Question 26

what is the impact of urinary genital surgery on growth and development?

Answer 26

• Between 3-6 years of age, child becomes curious about
  sexual differences
• Surgical intervention during this stage of development
  requires preparation to minimize negative impact of G & D
• There can be serious physical and psychological implication
  when genital defects and anomalies