UNIT 8 GENUITORY CHAPTER 45 CHAPTER 34 Flashcards
What is considered Geniutory dysfunction
Any dysfunction involving kidneys, ureter, bladder or urethra
Disorders may affect waste removal and/or fluid & electrolyte balance
Urinary tract malformations or malfunctions may be
congenital or acquired
Pediatric differences in Urinary Tract
Pediatric differences in Urinary Tract
Nephrons
Immature kidney function
Bladder capacity
Bladder control
What is the most common cause of Urinary Tract Infections?
A. h. phylori
B. C-diff
C. Dehydration
D. E. coli
D. E. coli
Which of the following are signs and symptoms of Urinary Tract Infection in pediatric patients?
SELECT ALL THAT APPLY
A. Nasal congestion
B. hyperkalemia
C. Severe rash
D. Foul smelling urine
E. Enuresis
F. Frequency
C. Severe rash
D. Foul smelling urine
E. Enuresis
F. Frequency
*incontinence in a previously
toilet-trained child,
*strong-smelling urine,
*frequency/urgency,
*anorexia,
*vomiting,
*persistent diaper rash,
*crying on urination
- Incontinenceinatoilet-trainedchild
- Frequencyorurgencyofvoiding
- Dysuria
- Grosshematuria
How would you diagnose Urinary Tract Infection
Diagnosis: U/A, culture
Managent of UTI’s
Management: Eliminate current infection,
prevent systemic spread of infection, preserve
renal function,
decrease risk factors
(poor hygiene/wiping while potty training, withholding
urine)
What is the definition of Enuresis?
bed wetting
What are the risk factors for Enuresis?
May be caused by
*structural defects,
*UTI,
*neurological deficits,
*diabetes,
*chronic renal failure
How is Enuresis diagnosed
Diagnosis: based on
symptoms
S/S of Enuresis
Manifestations: involuntary
passage of urine
How would you decrease episodes of Enuresis?
Management:
*limit evening fluids,
*empty bladder prior to
bed
What is Nephrotic Syndrome?
INFLAMMATORY PROCESS OF NEPHRONS IN KIDNEY
NO INFECTION
Clinical state that includes
proteinuria, hypoalbuminemia,
hyperlipidemia, and edema
urine +3 +2 dipstick
under 3.5 albumin
hypercholesterimia hdl over 200
Pathophysiology of Nephrotic syndrome
Pathophysiology:
disturbances cause basement
membrane of glomeruli to
become permeable to protein
What labs or signs symptoms would you suspect to see in patient
Labs:
*proteinuria (massive),
*hypoalbuminemia,
*hypercholesterolemia
*Generalized Edema,
*WEIGHT GAIN
*anorexia,
*irritability,
*lethargy
*Puffiness of face (facial edema):
* Diarrhea
* Anorexia
- Poor intestinal absorption
*massive proteinuria, hypoalbuminemia, edema, elevated serum lipids, anorexia, and pallor. The child gains weight.
Would blood pressure elevated or decreased in Nephrotic Syndrome?
A. Elevated
B. Decreased
B. Decreased
Blood pressure normal or slightly decreased
Are patients with Nephrotic Syndrome susceptible to infection?
A. NO
B.Yes
Susceptibility to infection
B.Yes
Nursing Management of Nephrotic syndrome
Focus:
Reduce excretion of urinary protein
Reduce edema
Prevent infection
Low-sodium diet
Diuretics
Corticosteroids x8-12 weeks
Relapses occur in 2/3 of kids
Nursing considerations:
Strict I&O, daily weight
Urine dipstick for albumin
Monitor VS, edema
What diet should a patient with Nephrotic syndrome be on ?
A. Low calorie, low protein
B. Low sodium, high protein
B. High in Vit-c , low in vitamin d
D. High sodium, low protein
B. Low sodium, high protein
CORTICOSTERIOD teaching
Corticosteroids x8-12 weeks
Relapses occur in 2/3 of kids
suppresses immune system ^
had hygiene stay away from large crowds
How would you monitor urine output in an infant ?
amount of wet diapers
Strict I&O, daily weight
Urine dipstick for albumin
Monitor VS, edema
The nurse reviews the record of a child who is sus- pected to have glomerulonephritis. Which state- ment that relates to this diagnosis would the nurse expect to hear from the child’s parents?
1. “The pediatrician said the kidneys are working well.”
2. “I noticed the urine was the color of cola lately.”
3. “I’m so glad they didn’t find any protein in the urine.”
4. “The nurse who admitted my child said the blood pressure was low.”
- “I noticed the urine was the color of cola lately.”
The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with ne- phrotic syndrome notes that which most common characteristic is associated with this syndrome?
1. Hypertension
2. Generalized edema
3. Increased urinary output
4. Frank, bright red blood in the urine
- Generalized edema
The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment ndings would the nurse expect to observe? Select all that apply.
1. Pallor
2. Edema
3. Anorexia
4. Proteinuria
5. Weight loss
6. Decreased serum lipids
- Pallor
- Edema
- Anorexia
- Proteinuria
A 7-year-old child is seen in a clinic, and the pedia- trician documents a diagnosis of nighttime (noc- turnal) enuresis. The nurse would plan to provide which information to the parents?
1. Nighttime (nocturnal) enuresis does not respond to treatment.
2. Nighttime (nocturnal) enuresis is caused by a psychiatric problem.
3. Nighttime (nocturnal) enuresis requires surgical intervention to improve the problem.
4. Nighttime (nocturnal) enuresis is usually out- grown without therapeutic intervention.
- Nighttime (nocturnal) enuresis is usually out- grown without therapeutic intervention.
S/S OF NEHRPHROTIC SYNDROME
■ Weight gain in the child
■ Periorbital and facial edema most prominent in the morning
■ Leg, ankle, labial, or scrotal edema
■ Decrease in urine output; urine dark and frothy
■ Ascites (uid in abdominal cavity)
■ Blood pressure normal or slightly decreased
■ Lethargy, anorexia, and pallor
■ Massive proteinuria
■ Decreased serum protein (hypoproteinemia) and elevated
serum lipid levels
What can cause Acute Glomerulonephritis
Glomerulonephritis refers to a group of kidney dis- orders characterized by inflammatory injury in the glomerulus, most of which are caused by an immunological reaction.
Most cases are postinfectious:
streptococcal infections
No symptoms 1-3 weeks
S/S of Acute Glomerulonephritis
*HYPERTENSION
*COLOR COLORED URINE (HEMATURIA)
*OLIGURIA
*PROTEINURIA
*EDEMA
■ Periorbital and facial edema that is more prominent in the morning, spreads to genial area throughout the day
■ Anorexia
■ Decreased urinary output
■ Cloudy, smoky, brown-colored (cola-colored) urine (hematuria)
■ Pallor, irritability, lethargy
■ In an older child: Headaches, abdominal or FLank pain, dysuria
■ Hypertension
Increased anti–streptolysin O titer (used to diagnose disor-
ders caused by streptococcal infections)
Does Acute Glomerulonephritis has hypoalbumenia?
A.Yes
B. No
B. No
ONLY NEPHROPHRITIC SYNDROME
Is reoccurrence common in Nephrotic Syndrome or Acute Glomerphritis
A. AG
B. NS
B. NS
Yes due to steroid therapy
Nursing Managent of AG
Supportive care; if VS stable, treat at home
* Sodium restriction, possible fluid restriction
* Strict I&O, daily weight in the morning before food
* VS q4h (esp BP)
* Recurrence uncommon
Low salt or low salt and high protein?
Match the diagnoses with the recommended diet
Nephrotic Syndrome
Acute Glomerphritis
Low salt= Acute Glomerphritis
low salt and high protein= Nephrotic Syndrome
