Renal System

Question 1

Disorder that is commonly the result of a GI infection with a particular strain of E.coli that produces a toxin which causes the destruction of RBCs, damage to the blood vessels in the kidneys, and a decrease in platelets

Answer 1

Hemolytic uremic syndrome (HUS)

Question 2

S/S of HUS

Answer 2

Abdominal pain, fever, N/V, bloody diarrhea, abnormal bleeding and increased bruising

Question 3

Labs associated with HUS

Answer 3

Decreased Hgb, Hct, and platelets
Elevated creatinine, presence of blood and protein in urine

Question 4

HUS treatment

Answer 4

Administration of IV fluids and packed RBCs for anemia

Question 5

Complications of HUS

Answer 5

AKI and CKD

Question 6

Prevention of HUS

Answer 6

Cook foods thoroughly, avoid unpasteurized milk and juice, ensure utensil and cooking surfaces are clean, avoid unsafe swimming areas, maintain good hand hygiene

Question 7

Backflow of urine into the ureters and sometimes into the kidneys caused by anatomic abnormality or nerve damage and may result in UTIs or pyelonephritis

Answer 7

Vesicoureteral reflux

Question 8

S/S of vesicoureteral reflux

Answer 8

Frequent UTIs and/or episodes of pyelonephritis, in babies — fussiness, poor feeding, vomiting, diarrhea

Question 9

Congenital abnormality that causes the baby’s bladder to be inside out, and a defect in the abdominal wall causes the bladder to be exposed to the external environment

Answer 9

Exstrophy of the bladder

Question 10

Nursing interventions prior to surgical repair of exstrophy of the bladder

Answer 10

Protect exposed bladder with a sterile, non-adherent dressing

Question 11

Nursing interventions/family education following surgical repair of exstrophy of the bladder

Answer 11

Immobilization of the lower extremities is required for several weeks, keep child calm, provide pain medication, closely monitor I&O, prevent formation of pressure injuries (high risk d/t immobilization)

Question 12

Congenital defects that result in the abnormal placement of the urethral meatus

Answer 12

Hypospadias and epispadias

Question 13

Disorder in which the urethral opening is on the ventral surface or underside of the penis

Answer 13

Hypospadias

Question 14

Disorder that is more common in males, but can also occur in females, in which the urethral opening os on the dorsal or top of the penis

Answer 14

Epispadias

Question 15

Characteristics of epispadias

Answer 15

In addition to the urethral opening being on top of the penis, a short, wide penis and abnormal curvature is typically present

Question 16

Important consideration if Hypospadias or epispadias requires surgical intervention

Answer 16

Baby should NOT be circumcised because the foreskin may be needed for surgical repair

Question 17

What medication class is used to decrease bladder spasms after surgical repair of Hypospadias or epispadias?

Answer 17

Anticholinergic agents such as oxybutynin