Pediatrics Test 2: GU Dysfunction

Question 0

What is hydrocele? How is it treated?

Answer 0

Fluid in scrotum
Usually spontaneous resolution within 1 year
Do transit luminaries due to increased fluid

Question 1

What is an inguinal hernia? And what is the treatment?

Answer 1

Protrusion of abdominal content through inguinal canal In scrotum
Bowel has dropped down through inguinal ring

Treatment is surgically closure of inguinal defect

Question 2

What is phimosis?

Answer 2

Narrowing of preputial opening of the foreskin

Can urinate but no stretch ability

Question 3

What is the treatment for phimosis?

Answer 3

Gentle stretching throug manual retraction or foreskin

Circumcision: full or partial can open on just one side

Question 4

What is hypospadius?

Answer 4

Urethral opening located behind the glans penis or anywhere along the VENTRAL SURFACE (belly surface)
Have difficulty aiming urine
Impedes successful fertilization and body self image

Question 5

Surgical correction of hypospadius?

Answer 5

Able to relocate urethra
Have multiple surgeries
Put a stent in to keep tube as open as possible
Protect surgical site from elimination by double diapering to cover both ends

Question 6

What is cryptorchidism? What is the treatment?

Answer 6

Failure of one or both testes to descend normally through inguinal canal
May descend spontaneously by 1 year ad because cant produce sperm and increased risk for testicular cancer
Treatment: surgery, pull into scrotum

Question 7

What I’d exstrophy ore bladder?

Answer 7

Externalization of bladder through anterior bladder wall
Bladder turned inside out
Kept wet with normal saline gauze

Question 8

What are predisposing factors to urinary tract infections?

Answer 8

Short urethra of female
Closure or urethra at end of urination may increase return of bacteria to bladder
Incomplete bladder emptying
Cn be caused by constipation or clothes

Question 9

How can you prevent urinary tract infection?

Answer 9

Teach correct wiping technique
Avoid bubble baths
Teach not to hold pee or poop
When urinate tell the. To pee and then try again to completely empty bladder
Drink fluid to flush out track
Et lots of fiber

Question 10

What are clinical manifestations of urinary tract infections?

Answer 10

Infants and children less then 2 years: failure to thrive, vomit, diarrhea, feeding problems
Older children: enuresis or daytime urination, fever, foul smelling urine, increased frequency, abdominal pain, costovertebral angle tenderness

Question 11

How do you diagnosis a urinary tract infection?

Answer 11

Urinalysis: 5-8 WBC, + gram stain

Question 12

What is treatment for UTI?

Answer 12

Trimethoprim-sulfamethoxazole (Bactrim)
Amoxicillin
Nitrofurantoin
Cephalexin

Question 13

What is acute glomerularnephritis?

Answer 13

Immune mediated disease characterized by diffuse changes in glomeruli of kidneys
Occurs primarily between 6-7

Question 14

How do you diagnose acute glomerularnephritis

Answer 14

ASO (anti strep) titters positive indicator for presence of streptococcal antibodies
High specific gravity
Low pH 
Hematuria
Leukocyturia
RBC cast
Proteinuria

Question 15

What are clinical manifestations of acute glomerularnephritis?

Answer 15

Dark colored urine
Lethargy
Anorexia
Abdominal pain
Vomiting
Headache
Oliguria
Facial puffiness
Edema
CVA tenderness
Hypertension

Question 16

Treatment and nursing measures for acute glomerularnephritis?

Answer 16

Supportive and treat complications
Low sodium diet and fluid restriction 
Management of electrolytes
Management of hypertension
Activity as tolerated
Parental education

Question 17

When do you know there is improvement with ate glomerularnephritis?

Answer 17

When they start urinating because can rid selves of fluid, hypertension goes away and weight decreases

Question 18

What are the primary characteristics of nephrotic syndrome?

Answer 18

Proteinuria
Hyposlbumin
Hyperlipidemia
Edema

Occurs between 2 and 7

Question 19

What are clinical manifestations of nephrotic syndrome?

Answer 19

Weight gain
Edema

Ascites
Pleural effusions
Anorexia
Abdominal pain
Diarrhea
Hypertension
Decreased urine
Pallor,  fatigue

Question 20

Diagnosis of nephrotic syndrome

Answer 20

Proteinuria: 3+
Total serum concentration low
Serm albumin low
Plasma lipids elevated

Question 21

Treatment and nursing meat for nephrotic syndrome

Answer 21

Low salt diet, fluid restriction
Diuretic therapy
Corticosteroids are first line treatment
Self limiting disease
Strict I&O
Activity as tolerated

Question 22

What is renal failure

Answer 22

Inability of kidneys to excrete waste

Azotemia: accumulation of nitrogenous waste within the blood
Uremia: retention of nitrogenous products produce toxic symptoms

Question 23

What s acute renal failure?

Answer 23

Sudden loss of ability to regulate volume and composition of urine

Question 24

What is acute renal failure caused by?

Answer 24

Dehydration
Surgical shock and trauma
Glomerular disease
Nephroloxic drugs
Obstructive uropathy

Question 25

What are clinical manifestations of acute renal failure?

Answer 25

Oliguria <1ml/kg/hr
Anuria: no urine at all
Nausea and vomiting
Drowsiness
Edema
Cardia arrhythmias from hyperkalemia

Question 26

What are the lab results of acute renal failure?

Answer 26

Increased BUN 
increased creatine
Metabolic acidosis
Hyponatremia 
Hyperkalemia 
Hypocalcemia

Question 27

What is treatment and nursing measure for acute renal failure?

Answer 27

Treat underlying cause
Manage complications
IV fluids to restore volume
Foley catheter and monitor output
Diuretics 
Oral fluid restriction, high carbohydrate diet
Manage hyperkalemia 
Anti hypertensives

Question 28

What are the types of renal replacement therapy?

Answer 28

Hemodyalisis: give mess after dialysis do d
Peritoneal dialysis: doesn’t require venous access but through abdomen
Kidney transplantation