Pediatrics Test 2: GU Dysfunction Flashcards
What is hydrocele? How is it treated?
Fluid in scrotum
Usually spontaneous resolution within 1 year
Do transit luminaries due to increased fluid
What is an inguinal hernia? And what is the treatment?
Protrusion of abdominal content through inguinal canal In scrotum
Bowel has dropped down through inguinal ring
Treatment is surgically closure of inguinal defect
What is phimosis?
Narrowing of preputial opening of the foreskin
Can urinate but no stretch ability
What is the treatment for phimosis?
Gentle stretching throug manual retraction or foreskin
Circumcision: full or partial can open on just one side
What is hypospadius?
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
Surgical correction of hypospadius?
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
What is cryptorchidism? What is the treatment?
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
What I’d exstrophy ore bladder?
Externalization of bladder through anterior bladder wall
Bladder turned inside out
Kept wet with normal saline gauze
What are predisposing factors to urinary tract infections?
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
How can you prevent urinary tract infection?
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
What are clinical manifestations of urinary tract infections?
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
How do you diagnosis a urinary tract infection?
Urinalysis: 5-8 WBC, + gram stain
What is treatment for UTI?
Trimethoprim-sulfamethoxazole (Bactrim)
Amoxicillin
Nitrofurantoin
Cephalexin
What is acute glomerularnephritis?
Immune mediated disease characterized by diffuse changes in glomeruli of kidneys
Occurs primarily between 6-7
How do you diagnose acute glomerularnephritis
ASO (anti strep) titters positive indicator for presence of streptococcal antibodies High specific gravity Low pH Hematuria Leukocyturia RBC cast Proteinuria
What are clinical manifestations of acute glomerularnephritis?
Dark colored urine Lethargy Anorexia Abdominal pain Vomiting Headache Oliguria Facial puffiness Edema CVA tenderness Hypertension
Treatment and nursing measures for acute glomerularnephritis?
Supportive and treat complications Low sodium diet and fluid restriction Management of electrolytes Management of hypertension Activity as tolerated Parental education
When do you know there is improvement with ate glomerularnephritis?
When they start urinating because can rid selves of fluid, hypertension goes away and weight decreases
What are the primary characteristics of nephrotic syndrome?
Proteinuria
Hyposlbumin
Hyperlipidemia
Edema
Occurs between 2 and 7
What are clinical manifestations of nephrotic syndrome?
Weight gain
Edema
Ascites Pleural effusions Anorexia Abdominal pain Diarrhea Hypertension Decreased urine Pallor, fatigue
Diagnosis of nephrotic syndrome
Proteinuria: 3+
Total serum concentration low
Serm albumin low
Plasma lipids elevated
Treatment and nursing meat for nephrotic syndrome
Low salt diet, fluid restriction Diuretic therapy Corticosteroids are first line treatment Self limiting disease Strict I&O Activity as tolerated
What is renal failure
Inability of kidneys to excrete waste
Azotemia: accumulation of nitrogenous waste within the blood
Uremia: retention of nitrogenous products produce toxic symptoms
What s acute renal failure?
Sudden loss of ability to regulate volume and composition of urine
What is acute renal failure caused by?
Dehydration Surgical shock and trauma Glomerular disease Nephroloxic drugs Obstructive uropathy
What are clinical manifestations of acute renal failure?
Oliguria <1ml/kg/hr Anuria: no urine at all Nausea and vomiting Drowsiness Edema Cardia arrhythmias from hyperkalemia
What are the lab results of acute renal failure?
Increased BUN increased creatine Metabolic acidosis Hyponatremia Hyperkalemia Hypocalcemia
What is treatment and nursing measure for acute renal failure?
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
What are the types of renal replacement therapy?
Hemodyalisis: give mess after dialysis do d
Peritoneal dialysis: doesn’t require venous access but through abdomen
Kidney transplantation
