QUIZ 5: CHAPTER 46: NURSING CARE OF A FAMILY WHEN A CHILD HAS A RENAL OR URINARY DISORDER

Question 1

• is also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder and the urethra.

Answer 1

Urinary System

Question 2

Purpose of the urinary system:

Answer 2

1. eliminate waste from the body,
2. regulate blood volume and blood pressure
3. control levels of electrolytes and metabolites
4. regulate blood pH

Question 3

• Remove waste products and drugs from the body.

Answer 3

Kidney

Question 4

• They continually tighten and relax forcing urine downward, away from the kidneys.

Answer 4

Ureters

Question 5

• The walls of this structure relax and expand to store urine, and contract and flatten to empty urine through the urethra.

Answer 5

Bladder

Question 6

• This tube allows urine to pass outside body

Answer 6

Urethra

Question 7

The amount of urine excreted in a 24-hour period

Answer 7

depends on fluid intake, kidney health, and age.

Question 8

• significant decrease in urine production

Answer 8

Oliguria

Question 9

• absence of urine production.

Answer 9

Anuria

Question 10

• a product released during muscle cell metabolism. A decrease in creatinine level indicated kidneys are not functioning as well as usual.

Answer 10

Creatinine

Question 11

• one of the most revealing tests of kidney function.

Answer 11

Urinalysis

Question 12

• 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.

Answer 12

Creatinine Clearance Test

Question 13

• provide Information about the size and contour of the kidneys

Answer 13

X-Ray Studies

Question 14

• A urinary tract infection (UTI), the presence of bacteria in urine, is diagnosed by a

Answer 14

Urine Culture

Question 15

• 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.

Answer 15

Blood Studies

Question 16

of the kidneys are used to show the size and density of kidney structures and adequacy of urine flow.

Answer 16

Computed tomography (CT) scans

Question 17

An ultrasound or — can detect differing sizes of kidneys or ureters and can differentiate between solid or cystic kidney masses.

Answer 17

magnetic resonance imaging (MRI)

Question 18

involves passing a thin biopsy needle into the kidney through the skin over the kidney.

Answer 18

Renal biopsy

Question 19

When the bladder first forms in utero, it is joined to the umbilicus by a narrow tube, the —.

Answer 19

PATENT URACHUS

Question 20

Midline closure defect that occurs during the 10th week of pregnancy.
Bladder lies exposed on the anterior abdominal wall.

Answer 20

EXSTROPHY OF THE BLADDER

Question 21

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.

Answer 21

Hypospadias (ventral aspect)-

Question 22

• newborn surgical procedure in which the urethra is extended to a normal position-may initially be performed to establish better urinary function

Answer 22

Meatotomy

Question 23

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.

Answer 23

URINARY TRACT INFECTION

Question 24

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

Answer 24

Honeymoon cystitis

Question 25

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.

Answer 25

Vesicoureteral reflux

Question 26

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.

Answer 26

Hydronephrosis

Question 27

is involuntary passage of urine past the age when a child should be expected to have attained bladder control.

Answer 27

Enuresis

Question 28

Enuresis may be nocturnal

Answer 28

occurs only at night

Question 29

diurnal

Answer 29

occurs during the day

Question 30

A few children will spill albumin into the urine when they stand upright for an extended period (postural proteinuria, also called pastoral albuminuria).

Answer 30

POSTURAL (ORTHOSTATIC) PROTEINURIA

Question 31

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).

Answer 31

KIDNEY AGENESIS

Question 32

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.

Answer 32

RENAL HYPOPLASIA

Question 33

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.

Answer 33

Prune belly syndrome

Question 34

, 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).

Answer 34

ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS

Question 35

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)

Answer 35

chronic glomerulonephritis

Question 36

altered glomerular. permeability due to fusion of the glomerular membrane surfaces, causes abnormal loss of protein in urine.

Answer 36

NEPHROTIC SYNDROME

Question 37

Approximately one quarter of the children who develop this type of purpura develop renal disease as a secondary complication.

Answer 37

HENOCH-SCHONLEIN SYNDROME NEPHRTIS

Question 38

an autoimmune disease in which autoantibodles and antigens cause deposits of complement in the kidney glomerulus

Answer 38

SYSTEMIC LUPUS ERYTHEMATOSUS

Question 39

With ---, the lining of glomerular arterioles becomes inflamed, swollen, and occluded with particles of platelets and fibrin.

Answer 39

HEMOLYTC-REMIC SYNDROME

Question 40

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

Answer 40

ACUTE RENAL FAILURE

Question 41

results from developmental abnormalities, when acute failure becomes long term, or when chronic kidney disease has caused extensive nephron destruction.

Answer 41

CHRONIC KIDNEY DISEASE

Question 42

Kidney Transplantation

Answer 42

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.