Pediatric Genitourinary Flashcards
What are physical signs associated with a UTI?
dysuria, suprapubic discomfort, hematuria, fever
What is considered a frequent UTI?
3 or more UTIs within a 6 month period
What does a UTI and a fever imply?
pyelonephritis
What is pyelonephritis?
inflammation of the upper urinary tract and kidneys
What is urosepsis?
febrile UTI with systemic signs of bacterial illness, blood culture reveals urinary pathogen
What is the most common uropathogen?
escherichia coli
What type of bacteria is escherichia coli?
gram-negative enteric organisms
Why are females more likely to get a UTI?
the urethra is shorter (2cm in young girls and 4cm in women)
What do men produce that inhibit the entry and growth or urinary pathogens?
prostatic secretions
What is the most important hose factor in the occurrence of a UTI?
Urinary stasis (incomplete bladder emptying)
Why may urinary stasis occur?
Vesicoureteral reflux
Anatomic abnormalities
Dysfunction of the voiding mechanism
Extrinsic or ureteral or bladder compression that may be caused by constipation
What is something that is important to encourage to decrease the risk of UTIs?
fluid intake
What are the clinical manifestations of a UTI in newborns/infants?
poor feeding, vomiting, FTT, frequent urination, straining/screaming on urination, foul-smelling urine, fever, dehydration
What are common clinical manifestations of a UTI in children?
poor appetite, vomiting, growth failure, enuresis, incontinence, frequent urination, painful urination, hematuria, fatigue, abdominal/back pain
How is a urinary tract infection diagnosed?
by detection of bacteria in urine culture
What may show up on a urine dipstick analysis if a UTI is present?
leukocyte esterase and nitrites
Why are nitrites found in the presence of a UTI?
nitrates convert to nitrites in the presence of most gram-negative enteric bacteria
What is the most common cause of false-positive UTI results in children?
contamination of the urine
What are the objective of urinary tract infection treatment?
eliminate current infection, identify factors to reduce risk of recurrence, prevent systemic spread of infection, preserve renal function
How is antibiotic therapy initiated for a urinary tract infection?
based on identification of pathogen and the child’s history of antibiotic use as well as the location of infection
What are common antibiotics prescribed to treat UTIs?
Penicillins, sulfonamides, cephalosporins, nitrofuratonin (not for pyelonephritis)
When is surgical correction done for UTIs?
for anatomical defects such as Primary vesicoureteral reflux or bladder neck obstruction
What are common UTI prevention measures?
proper perineal hygiene, avoiding tight clothing/diapers, wearing cotton underwear vs nylon, encourage child to void frequently and not “hold” urine, encourage adequate fluid intake, avoid constipation, empty bladder completely with each void
What is vesicoureteral reflux?
abnormal retrograde flow of urine from bladder into upper urinary tract
