objective 10.6 Flashcards
what is an expected urine output for a child?
1 to 2mL/kg/hr
what is the expected urine output for older children?
30mL/hr
what is the bladder capacity at birth?
50mL
what is the bladder capacity of an adult?
700mL
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
urinary tract infection
what are interventions to prevent UTI?
- 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
infection of the urethra
urethritis
inflammation of the bladder
cystitis
bacteria in the urine
bacteriuria
infection of the kidney and the renal pelvis
pyelonephritis
infection of the ureters
ureteritis
backward flow of urine from the bladder to the kidneys with voiding
vesicoureteral reflux
what are the S&S of a uti in infants?
fever, frequent urination, foul-smelling urine, persistent
diaper rash, vomiting & chills
what are the S&S of a uti in older children?
urinary frequency, pain during micturition, onset of
bed-wetting in a previously “dry” child, and abdominal pain may
be present
what is a treatment of a uti?
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
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
phimosis
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
paraphimosis
a congenital defect in which the urinary meatus is located
on the lower portion of the shaft
* may be accompanied by chordee
hypospadias
urinary meatus is on the upper surface of the penis
epispadias
what is the treatment of hypospadias and epispadias?
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
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
nephrotic syndrome
what are the symptoms of nephrotic syndrome?
Proteinuria & Edema (first
around eyes, ankles then
generalized),
Wt. Gain
Abd may be distended (Ascites)
Pale, irritable, and listless, poor
appetite
what is the treatment of nephrotic syndrome?
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
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
cryptorchidism
what is the treatment/nursing care of cryptorchidism?
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
what is the impact of urinary genital surgery on growth and development?
- 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
