Renal/Urinary

Question 1

What are the general interventions for any kidney or urinary disorder?

Answer 1

• monitor intake and output
• monitor vital signs
• get a daily weight at same time each day

Question 2

What is the last resort treatment for renal diseases that cause kidney failure?

Answer 2

Dialysis or Kidney transplant.

Question 3

Describe:

Glomerulonephritis

Answer 3

An autoimmune disease that damages the glomeruli.

It is caused by untreated strep throat or lupus that causes inflammation in the kidneys.

Question 4

What are the severe complications of untreated glomerulonephritis?

Answer 4

• kidney failure and heart failure due to fluid build-up
• hypertensive encephalopathy and seizures due to toxin build-up

Question 5

What are the urine characteristics with glomerulonephritis?

Answer 5

• hematuria: smokey-brown urine
• proteinuria: foamy urine

The glomeruli are no longer able to filter blood, protein, or fluids properly.

Question 6

What are the diet restrictions for glomerulonephritis?

Answer 6

• limit sodium and fluids if edematous
• limit potassium if oliguria

Question 7

Medications:

Glomerulonephritis

Answer 7

• diuretics
• antihypertensives
• antibiotics for strep infection

Question 8

What are the interventions for glomerulonephritis due to toxin build-up in the blood?

Answer 8

Seizure precautions and anticonvulsants if seizures occur.

Question 9

Describe:

Nephrotic syndrome

Answer 9

An autoimmune disease where the nephrons are damaged.

The cause is unknown, but risk factors are diabetes mellitus and lupus.

Question 10

What are the characteristic signs and symptoms of nephrotic syndrome?

Answer 10

• massive proteinuria: foamy urine
• hypoalbuminemia
• edema

Question 11

Medications:

Nephrotic syndrome

Answer 11

• diuretics
• corticosteroids to decrease inflammation
• immunosuppressants

Question 12

What is the teaching to the parents for a child with nephrotic syndrome?

Answer 12

To have child avoid people with infections since child may be on immunosuppressants.

Question 13

Describe:

Epispadias and hypospadias

Answer 13

Congenital defects in which the ureter opening is in the wrong spot.

Question 14

How is epispadias and hypospadias treated?

Answer 14

Surgery to correct the opening: is usually done between 6 - 12 months old before toilet training begins.

Question 15

Is a child with epispadias or hypospadias circumcised?

Answer 15

Usually not, since the surgeon may use the foreskin to reconstruct the urethral opening.

Question 16

What tube will the infant have after surgery for urethral reconstruction?

Answer 16

Child may have a urinary diversion or stent to keep the urethral opening patent while the urinary meatus (opening) is healing.

Question 17

After how long would the surgeon be called if there is no urine output after urethral surgical reconstruction?

Answer 17

Call after 1 hour: there may be a kink or sediment blocking the opening.

Question 18

Medications:

Urethral reconstruction surgery

Answer 18

• anticholinergics to relieve bladder spasms
• antibiotics
• analgesics

Question 19

What is the teaching to parents about home care for a child with urethral surgery reconstruction?

Answer 19

1. no tub baths until tube or stent is removed
2. monitor fluid intake and output at home by monitoring wet diapers
3. monitor for signs and symptoms of infection
   
   • purulent drainage
   • fever
   • excessive edema