Week 2 GU Flashcards
How to estimate bladder size
Estimated by adding 2 years of age to the child’s age and that gives you the size of the bladder. For example, a 3yr old +2= a 5 ounce bladder
When does urine excretion occur
12th week gestation
In general what is the urinary output per hour for the pediatric population
1/2 ml/kg/hour
Intravenous pyelogram
IVP, contrast dye given in IV, shows kidney excretion
Note: be aware of the possibility of an iodine allergy; inquire about family hx of allergy to iodine or shellfish
normal pH of urine
4.5-8
normal specific gravity
< or = to 1.010
normal protein level
Negative < 150 mg / 24 hr
Primary vs. Secondary Nephrotic Syndrome
Primary – disease that directly affects only the kidney
Secondary – results from a systemic disease, drugs, or toxin
S/S of pediatric nephrosis
Edema
Massive proteinuria
Hypoalbuminemia
Hypoproteinemia
Hyperlipidemia
Altered immunity - manifests as loss of immunoglobulins
*usually preceded by a URI or other infeciton
As MCNS progresses, everything will swell, leading to further complications such as *MCNS usually comes on fairly fast
Respiratory distress: related to pleural effusion
Thrombosis
Heart failure: related to pulmonary edema
Renal failure
Lab and Diagnostic test in Nephrotic syndrome
urine dip stick - proteinuria.
mild hematuria is also present.
serum protein and albumin levels will be low.
With continued nephrotic syndrome, creatine and BUN may also become elevated
Clinical therapy for Nephrotic syndrome
Decreasing proteinuria Relieving edema Symptom management Nutrition improvement Preventing infection LOW SALT DIET <2g/Na/Day *** Need to carefully monitor electrolyte levels due to risk of hypovolemia, hyponatremia, and hypokalemia from DIURETICS!
Patho of Hemolytic-uremic syndrome
acute renal failure d/t toxins from infection damaging lining of glomerular arterioles causing endothelial swelling
Events preceded by URI or GI infection
HUS- Hemolytic-uremic syndrome presents as
Hypertensive Pale Acute renal sx Decreased H and H Monitoring for ecchymosis and petechiae Elevated creatinine and BUN *Tx siblings too! *cook meat to 155
Diagnosis for MCNS protein urinalysis
3+ to 4+ protein
