Peds Test # 2 GU

Question 1

Cystitis Vs. Pyelonephritis

Answer 1

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).

Question 2

What are the 6 SxS of a UTI in an infant?

Answer 2

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

Question 3

What are the 6 SxS of a UTI in a child?

Answer 3

1) Abdominal or supra public pain
2) Voiding frequency
3) Voiding urgency
4) Dysuria
5) New or ⬆ incidence of enuresis
6) Fever

Question 4

What are the 4 SxS of Pyelonephritis?

Answer 4

Same as UTI, plus:

1) High fever & chills
2) Back pain
3) Costovertebral angle tenderness
4) N & V

Question 5

What are the 3 different methods used to diagnose a UTI?

Answer 5

1) Urinalysis/Urine culture
2) VCUG (Voiding Cystourethrogram) - uses radiology to check for urinary reflux back into the ureters.
3) Ultrasound or CT

Question 6

What are the 3 nursing interventions listed for a patient with a UTI?

Answer 6

1) Assess fluid & electrolytes
2) Give antibiotics
3) Assess renal impairment: may give falsely low specific gravity

Question 7

What 7 patient teachings should be implemented to prevent UTIs?

Answer 7

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

Question 8

How is Vesiculourethral Reflux (VUR) treated?

Answer 8

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

Question 9

Describe the etiology and epidemiology of of Acute Postinfectious Glomerulonephritis (AGN).

Answer 9

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.

Question 10

What are the SxS of AGN?

Answer 10

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

Question 11

What methods are used to diagnose AGN?

Answer 11

1) Elevated ESR and lipid levels

2) Positive ASO titer confirms the streptococcal infection

Question 12

What types of meds are used in the Tx of AGN?

Answer 12

1) Antibiotics
2) Diuretics
3) Antihypertensives

Question 13

Which nursing interventions should be implemented for a patient with AGN?

Answer 13

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

Question 14

Describe the pathophysiology of Nephrotic Syndrome (NS), when does it happen an to whom?

Answer 14

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.

Question 15

What are the SxS of Nephrotic Syndrome?

Answer 15

1) Edema w/weight gain
2) Massive proteinuria (frothy urine)
3) Hypoalbuminemia
4) Hyperlipidemia
5) Fatigue/Abd pain
6) Nomotensive (normal BP)
7) Anorexia

Question 16

What methods are used to diagnose Nephrotic Syndrome?

Answer 16

1) Proteinuria of 3+ or 4+ (should be 0)
2) Hematuria (may be microscopic)
3) Hypoalbumenia
4) Hyperlipidemia
5) Kidney biopsy

Question 17

What types of meds/methods are used to manage Nephrotic Syndrome?

Answer 17

1) Corticosteroids (< proteinuria)
2) Diuretics (< edema)
3) Albumin administration
4) Antibiotics (prevent infection)
5) No added salt
6) Fluid restriction (if severe edema)

Question 18

What is Wilm’s Tumor and when does it occur?

Answer 18

Wilm’s Tumor (aka Nephroblastoma) is a type of kidney cancer that happens in kids ages 3-4 yrs old.

Question 19

What are the SxS of Wilm’s Tumor (Nephroblastoma)?

Answer 19

1) Often Asymptomatic
2) Nontender, firm, flank mass
3) Abd pain
4) Vomiting
5) Hematuria (may be microscopic)
6) Anemia
7) Hypertension

Question 20

What methods are used to diagnose Wilm’s Tumor?

Answer 20

1) Physical assessment to ID the mass
2) Abd ultrasound
3) CT
4) MRI

Question 21

What are the methods of Tx used for patients with Wilm’s Tumor?

Answer 21

1) Surgery
2) Chemotherapy
3) Radiation for stage 2-4

Question 22

Why should you not palate the mass of a patient with Wilm’s Tumor?

Answer 22

Because palpating may cause pieces of the tumor to break off and further complicate things

Question 23

How is Hypospadias treated?

Answer 23

1) No circumcision

2) Surgery (urethroplasty) before age 3