QUIZ 5: CHAPTER 46: NURSING CARE OF A FAMILY WHEN A CHILD HAS A RENAL OR URINARY DISORDER Flashcards
- is also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder and the urethra.
Urinary System
Purpose of the urinary system:
- eliminate waste from the body,
- regulate blood volume and blood pressure
- control levels of electrolytes and metabolites
- regulate blood pH
- Remove waste products and drugs from the body.
Kidney
- They continually tighten and relax forcing urine downward, away from the kidneys.
Ureters
- The walls of this structure relax and expand to store urine, and contract and flatten to empty urine through the urethra.
Bladder
- This tube allows urine to pass outside body
Urethra
The amount of urine excreted in a 24-hour period
depends on fluid intake, kidney health, and age.
- significant decrease in urine production
Oliguria
- absence of urine production.
Anuria
- a product released during muscle cell metabolism. A decrease in creatinine level indicated kidneys are not functioning as well as usual.
Creatinine
- one of the most revealing tests of kidney function.
Urinalysis
- Glomerular filtration rate - rate at which substances are filtered from blood to the urine measures by the Creatinine amount of creatinine excreted in 24 hours.
Creatinine Clearance Test
- provide Information about the size and contour of the kidneys
X-Ray Studies
- A urinary tract infection (UTI), the presence of bacteria in urine, is diagnosed by a
Urine Culture
- A blood urea nitrogen (BUN) test measures the level of urea in blood and is used to assess glomerular function, or how well the kidneys can clear this from the bloodstream.
Blood Studies
of the kidneys are used to show the size and density of kidney structures and adequacy of urine flow.
Computed tomography (CT) scans
An ultrasound or — can detect differing sizes of kidneys or ureters and can differentiate between solid or cystic kidney masses.
magnetic resonance imaging (MRI)
involves passing a thin biopsy needle into the kidney through the skin over the kidney.
Renal biopsy
When the bladder first forms in utero, it is joined to the umbilicus by a narrow tube, the —.
PATENT URACHUS
Midline closure defect that occurs during the 10th week of pregnancy.
Bladder lies exposed on the anterior abdominal wall.
EXSTROPHY OF THE BLADDER
is a urethral defect in which the urethral opening is not at the end of the penis but on the ventral (lower) aspect of the penis.
Hypospadias (ventral aspect)-
- newborn surgical procedure in which the urethra is extended to a normal position-may initially be performed to establish better urinary function
Meatotomy
more often in females than in males; urethra is shorter in girls and close to vaginal and anus
Most often as an ascending infection from the perineum and are gram-negative rods such as E. coli.
URINARY TRACT INFECTION
refers to lower UTI seen in young women shortly after they initiate a first sexual relationship. Such infections occur in connection with the local irritation and inflammation caused by initial coitus
Honeymoon cystitis
refers to retrograde flow of urine from the bladder into the ureters.
Valves that guard the entrance from the bladder to the ureter are defective, bladder pressure that is stronger than usual, or ureters that are implanted at abnormal sites or angles.
Vesicoureteral reflux
is enlargement of the pelvis of the kidney with urine as a result of back-pressure in the ureter.
The back-pressure is generally caused by obstruction, either of the ureter or of the point where the ureter joins the bladder, as with vesicoureteral reflux.
Hydronephrosis
is involuntary passage of urine past the age when a child should be expected to have attained bladder control.
Enuresis
Enuresis may be nocturnal
occurs only at night
diurnal
occurs during the day
A few children will spill albumin into the urine when they stand upright for an extended period (postural proteinuria, also called pastoral albuminuria).
POSTURAL (ORTHOSTATIC) PROTEINURIA
means lack of growth (literally, lack of a beginning) or that no organ formed in utero.
absence of Kidneys in a newborn is suggested when the volume of amniotic fluid on ultrasound or at birth Is less than normal (oligohydramnios).
KIDNEY AGENESIS
means reduced growth.
Hypoplastic kidneys contain fewer lobes than normal kidneys and are small and underdeveloped.
The child with hypoplastic kidneys, in addition to having poor kidney function, may develop hypertension from stenosis of the renal arteries.
RENAL HYPOPLASIA
is severe urinary tract dilation that develops as early as intrauterine life from an unknown cause.
Occurring mainly in boys, the severe dilation causes back pressure and destruction of kidneys.
Prune belly syndrome
, Inflammation of the glomeruli or the kidney, may occur as a separate entity but usually occurs as an immune complex disease after infection with nephritogenic streptococci (most commonly subtypes of group A beta-hemolytic streptococci).
ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS
Although — occasionally follows acute glomerulonephritis or nephritic syndrome, it also occurs as a primary disease (or after acute glomerulonephritis that was clinically so mild it was undiagnosed)
chronic glomerulonephritis
altered glomerular. permeability due to fusion of the glomerular membrane surfaces, causes abnormal loss of protein in urine.
NEPHROTIC SYNDROME
Approximately one quarter of the children who develop this type of purpura develop renal disease as a secondary complication.
HENOCH-SCHONLEIN SYNDROME NEPHRTIS
an autoimmune disease in which autoantibodles and antigens cause deposits of complement in the kidney glomerulus
SYSTEMIC LUPUS ERYTHEMATOSUS
With —, the lining of glomerular arterioles becomes inflamed, swollen, and occluded with particles of platelets and fibrin.
HEMOLYTC-REMIC SYNDROME
occurs in either an acute or chronic form.
The acute form most often occurs because of a sudden body insult, such as severe dehydration.
The chronic form results from extensive kidney disease, such as hemolytic-uremic syndrome or glomerulonephritis
ACUTE RENAL FAILURE
results from developmental abnormalities, when acute failure becomes long term, or when chronic kidney disease has caused extensive nephron destruction.
CHRONIC KIDNEY DISEASE
Kidney Transplantation
The ultimate possibility for prolonging the life of children with renal failure is kidney transplantation.
With complete renal failure, children who have extensive hypertension may have their damaged kidneys removed and may be placed on hemodialysis to await kidney transplantation.
