Peds Test # 2 GU Flashcards
Cystitis Vs. Pyelonephritis
1) Cystitis - A lower UTI that involves the urethra or bladder
2) Pyelonephritis - An upper UTI that involves the ureters, renal pelvis, and renal parynchema. (May be acute or chronic).
What are the 6 SxS of a UTI in an infant?
1) Fever (hypothermia in a neonate)
2) Irritability
3) Crying when voiding
4) Change in urine odor or color
5) Poor weight gain
6) Feeding difficulties
What are the 6 SxS of a UTI in a child?
1) Abdominal or supra public pain
2) Voiding frequency
3) Voiding urgency
4) Dysuria
5) New or ⬆ incidence of enuresis
6) Fever
What are the 4 SxS of Pyelonephritis?
Same as UTI, plus:
1) High fever & chills
2) Back pain
3) Costovertebral angle tenderness
4) N & V
What are the 3 different methods used to diagnose a UTI?
1) Urinalysis/Urine culture
2) VCUG (Voiding Cystourethrogram) - uses radiology to check for urinary reflux back into the ureters.
3) Ultrasound or CT
What are the 3 nursing interventions listed for a patient with a UTI?
1) Assess fluid & electrolytes
2) Give antibiotics
3) Assess renal impairment: may give falsely low specific gravity
What 7 patient teachings should be implemented to prevent UTIs?
1) Wipe front to back
2) Keep foreskin as clean as possible
3) Avoid holding in urine (void at least 4X a day)
4) Avoid tight clothing or diapers
5) Use cotton, not synthetic underwear
6) Avoid bubble baths
7) Girls should void immediately after sex
How is Vesiculourethral Reflux (VUR) treated?
1) Grades 1-3 - Low dose antibiotics
2) Grades 4-5 - Surgery, reimplant the ureters into the bladder and/or put stents in the ureters
Describe the etiology and epidemiology of of Acute Postinfectious Glomerulonephritis (AGN).
Glomerulonephritis is an inflammation of the glomeruli of the kidneys usually in response to group A beta-hemolytic streptococcal infection of the skin or pharynx.
Incidence is highest in children 5-8 yrs and more common in boys.
What are the SxS of AGN?
1) Hematuria
2) Periorbital and ankle edema > in the a.m.
3) ⬇ urine output with proteinuria
4) Febrile/lethargic
5) Abd pain
6) Headache
7) Hypertension
8) ⬆ BUN & ⬆ Creatinine
What methods are used to diagnose AGN?
1) Elevated ESR and lipid levels
2) Positive ASO titer confirms the streptococcal infection
What types of meds are used in the Tx of AGN?
1) Antibiotics
2) Diuretics
3) Antihypertensives
Which nursing interventions should be implemented for a patient with AGN?
1) Daily weight / Strict I & O
2) Assess BP & respiration
3) Prevent skin breakdown
4) Low or no Na+ diet
5) Limit fluid if ordered
6) Encourage rest in acute phase
Describe the pathophysiology of Nephrotic Syndrome (NS), when does it happen an to whom?
NS is an increased permeability of the glomerular membrane permitting albumin to pass through to the urine.
- It occurs btw the ages of 2-7 yrs with a 2:1 ratio of boys to girls.
What are the SxS of Nephrotic Syndrome?
1) Edema w/weight gain
2) Massive proteinuria (frothy urine)
3) Hypoalbuminemia
4) Hyperlipidemia
5) Fatigue/Abd pain
6) Nomotensive (normal BP)
7) Anorexia
What methods are used to diagnose Nephrotic Syndrome?
1) Proteinuria of 3+ or 4+ (should be 0)
2) Hematuria (may be microscopic)
3) Hypoalbumenia
4) Hyperlipidemia
5) Kidney biopsy
What types of meds/methods are used to manage Nephrotic Syndrome?
1) Corticosteroids (< proteinuria)
2) Diuretics (< edema)
3) Albumin administration
4) Antibiotics (prevent infection)
5) No added salt
6) Fluid restriction (if severe edema)
What is Wilm’s Tumor and when does it occur?
Wilm’s Tumor (aka Nephroblastoma) is a type of kidney cancer that happens in kids ages 3-4 yrs old.
What are the SxS of Wilm’s Tumor (Nephroblastoma)?
1) Often Asymptomatic
2) Nontender, firm, flank mass
3) Abd pain
4) Vomiting
5) Hematuria (may be microscopic)
6) Anemia
7) Hypertension
What methods are used to diagnose Wilm’s Tumor?
1) Physical assessment to ID the mass
2) Abd ultrasound
3) CT
4) MRI
What are the methods of Tx used for patients with Wilm’s Tumor?
1) Surgery
2) Chemotherapy
3) Radiation for stage 2-4
Why should you not palate the mass of a patient with Wilm’s Tumor?
Because palpating may cause pieces of the tumor to break off and further complicate things
How is Hypospadias treated?
1) No circumcision
2) Surgery (urethroplasty) before age 3
