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Pediatrics > Alterations in Genitourinary Function > Flashcards

Alterations in Genitourinary Function Flashcards

1
Q

UTI

A

Infection of bacterial, viral, fungal origin that occurs in the urinary tract
-second mores common infections in children

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2
Q

Cystitis

A

lower UTI that involves urethra or bladder

females more prone due to short urethra

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3
Q

pyelonephritis

A

upper UTI that involves the ureters, renal pelvis, and renal parynchema
may be acute or chronic

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4
Q

UTI sxs (infants)

A 
nonspecific
fever or hypothermia (neonate)
irritability
dysuria (crying when voiding)
change in urine odor or color
poor weight gain
feeding difficulties
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5
Q

UTI sxs (children)

A 
abdominal or suprapubic pain
voiding frequency
voiding urgency
dysuria
new or increased incidence of enuresis
fever
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6
Q

Pyelonephritis sxs

A 
same as UTI &....
high fever, chills
back pain
costovertebral angle tenderness
N/V
appears sick (toxic)
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7
Q

UTI Dx

A

urinalysis
urine culture
VCUG: voiding cystourethrogram
ultrasound or CT

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8
Q

UTI RN Interventions

A

Assess fluid/ lyte status
ABX: IV or PO
renal impairment: falsely low specific gravity

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9
Q

UTI prevention education

A 
wipe from front to back
keep foreskin as clean as possible
avoid holding urine, empty bladder
void at least qid
avoid tight clothing or diapers
use cotton underwear
avoid bubble baths
girls void immediately after sex
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10
Q

VUR Dx

A
  • Hx of UTIs
  • VCUG: Voiding cystoeurethrogram
    • Dye into bladder via catheter
    • x-rays taken before, during and after voiding
    • visualize: bladder, urethra reflux
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11
Q

VUR Management

A

Most can be treated medically: Grades I-III
low dose abx
frequent urine cultures

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12
Q

VUR surgical Management

A

Surgical criteria

  • Grades IV, V
  • recurrent UTI (w/ abx tx)
  • Noncompliance w/ abx
  • intolerance to abx
  • VUR after puberty in females
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13
Q

VUR surgery

A 
Reimplant the ureters into bladdder
stents into ureters
foley
postop abx until Normal VCUG
-3 months
-1 year
-3 years
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14
Q

Acute Postinfectious Glomerulonephritis (AGN)

A

inflammation of the glomeruli of the kidneys

highest incidence in 5-8 yrs and more common in boys than girls

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15
Q

AGN clinical manifestation

A 
hematuria: mild-gross (tea colored)
periorbital and ankle edema > in AM
< UO
febrile/ lethargic
abdominal pain
headache
HTN
urine slight-mod> protiens
> BUN > creatinine
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16
Q

AGN Dx test

A
  • ESR elevated and lipid levels elevated

- + ASO titer confirms the streptococcal infection

17
Q

AGN Tx

A

relief of s/s & supportive therapy
diuretics
antihypertensives
Abx

18
Q

AGN RN Interventions

A 
Daily weight, strict I/O
Assess BP
resp assessment
prevent skin breakdown
low Na Diet
limit fluid if ordered
encourage rest in acute phase
19
Q

Nephrotic Syndrome (NS)

A 
edema
massive protienuria
hypoalbuminemia
hyperlipidemia
altered immunity
Classified as congenital, primary or secondary
Occurs 2-7 years
boys> girls
20
Q

NS s/s

A 
edema/ weight gain
massive protienuria (frothy urine)
hyperabuminemia
hyperlippidemia
fatigue/ abd pain
nomotensive
anorexia
21
Q

NS Dx

A 
protienuria
possible microscpic hematuria
hypoalbuminemia
hyperlipidemia
kidney biopsy
22
Q

NS Management

A 
corticosteroids (< protienuria)
diuretics (< edema)
possible albumin administration
ABX: prevent infection
no added salt diet
fluid restriction (if severe edema)
23
Q

NS RN Assessment

A

hydration status
monitor edema/ I&O
vital signs: BP and temp

24
Q

NS Patient education

A

corticosteroids common side effects include > apetite, hyperglycemia, decreased resistance to inf., aseptic technique to prevent infection

25
Q

Wilms Tumor (nephroblastoma)

A

embrionic tissue origin
encapsulated tumor
peaks 3-4 yrs

26
Q

Wilms s/s

A 
Nontender, firm, flank mass
often asymptomatic
abdominal pain
vomiting
mocorscopic-gross hematuria
anemia 
HTN
27
Q

Wilms Dx

A 
physical assessment ID mass
abdominal ultrasound
eval for mestasis
-CT
-MRI
28
Q

Wilms Management

A 
don't palpate flank or abdomen
surgery
chemo
radiation: stages II-IV
survival: overall > 90%
recurrence 50%
29
Q

Hypospadias

A

congenital defect

urethral opening on ventral side of penis

30
Q

hypospadias s/s

A 
abnormal meatus placement
altered voiding stream
chordee: ventral curvature of penis caused by a fiberous band
may occur with
-undescended testes
-inguinal hernia
31
Q

Mypospadias Management

A

No circumcision
OR correction before 3 yrs
OR urethroplasty

32
Q

Post OP care

A

monitor urine output

catheter care

Pediatrics (8 decks)

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