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Flashcards in Exam 2 Deck (20)
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1
Q

What health care conditions would decrease fluid requirements?

A
  • Heart failure
  • Oligouric renal failure
  • Increased ICP
  • Mechanical ventilation
  • SIADH
  • Post operative
2
Q

What health care conditions would increase fluid requirements?

A
  • Fever
  • Vomitting
  • Diarrhea
  • Diabetes insipidus
  • Increased UOP in renal failure
  • Burns
  • Shock
  • Tachypenia
3
Q

Children have lower GFR than adults until age 2: Normal urine output

A

Newborn is 1/2 mL/kg/hour

Child is 1 mL/kg/hour

4
Q

GU Possible problems: more susceptible to trauma

A
  • Fluid status problems and fluids eqilibrium infants and children are more vulnerable to fluid and electrolyte imbalances
  • Increased proportion of water content and greater surface area
  • Increased metabolic rate which increases HR, so water must be replenished
  • immature kidneys
  • Immature homeostatic regulation system
  • Inability to shiver/sweat control temp.
  • Increased daily exchange of extracellular fluid.
5
Q

Structures involved in GU system

A

Kidneys
Ureters
Bladder
Urethra

6
Q

Dehydration Assessment

A
  • Skin turgor
  • Mucous membranes
  • UOP & frequency
  • Tears
  • Tachycardia
  • Lethargy
  • Usual type and amount of fluid intake
  • Stools: # and consistency
  • Fontanels
  • Sunken eyes
  • Dry skin
  • Rapid deep breathing
  • Shock (tachycardia-earliest sign)
  • Metabolic acidosis
  • Diagnostics: Concentrated urine, blood in urine, increased BUN, altered electrolytes
7
Q

Nursing considerations/interventions for dehydration

A

1) Weight (need that baseline)
2) VS I&Os (weigh diapers)
3) Oral fluids
4) No potassium
5) Correct metabolic acidosis
6) Monitor labs

8
Q

Dehydration: What is it? Why does it happen?

A

1) Output>Intake
2) Excessive fluid loss
3) Inadequate intake
4) Mild 5% pre-illness weight, moderate: 5-10% pre-illness weight, severe: >10% pre-illness weight

9
Q

Mild dehydrate S/S

A
  • Slight thirst

- normal pulse, RR, BP, weight loss (3-5% in infants, 3-4% in children), normal behavior, normal mucous membranes

10
Q

Moderate dehydration S/S

A
  • Slightly increased pulse, RR, Normal to orthostatic BP
  • Increased thirst
  • dry mucous membranes
  • weight loss (6-9% in infants, 6-8% in children)
  • Irritable
11
Q

Severe dehydration S/S

A
  • Pulse is very increased
  • Hyperpnea
  • BP is orthostatic to shock
  • Intense thirst
  • Parched mucous membranes
  • Weight loss (>/= 10% in infants, 10% in children)
12
Q

UTI: What is it? Why does it happen?

A
  • May involve upper or lower urinary tract

- Increased number of microogranisms

13
Q

UTI Risk

A
  • 2-6 years
  • More often in girls than boys (except for infants) because of how they wipe
  • Urinary stasis
14
Q

UTI assessment

A
  • Abdominal pain
  • Flank pain
  • Foul smelling urine
  • Jaundice in newborns
  • Poor feeding
  • Flu-like symptoms
  • Urinary incontinence
  • Diagnostics: Urine C&S, BUN, Creatine, KUB
15
Q

Nursing considerations/interventions for UTI’s

A
  • Prevention

- Educate s/s

16
Q

Medical management for UTI’s

A
  • Antibiotics
  • Hydration
  • Treat underlying cause
17
Q

Types of UTI’s

A

1) Recurrent: repeated episodes
2) Persistent: bacteriuria despite antibiotics
3) Febrile: typically indicates pyelonephritis
4) Cystitis: Inflammation of the bladder
5) Pyelonephritis: upper urinary tract and kidneys
6) Urosepsis: bacterial illness; urinary pathogens in blood

18
Q

Acute Glomerulonephritis (AGN) What is it? Patho?

A
  • Inflammation of glomeruli (kidney filtration system)
  • May lead to acute renal failure and heart failure
  • May be a primary or secondary event
  • Think infection with no UOP
19
Q

Acute Glomerulonephritis (AGN) Risks

A
  • Most common after a post-strep infection
  • May show after strep infection, pneumococcal infection or viral infection- shows up to 10-14 days after primary infection
20
Q

Acute Glomerulonephritis (AGN) Assessment

A
  • Oliguria
  • HTN
  • Cardiac congestion
  • Peri-orbital and peripheral edema
  • Hematuria, increased specific gravity, mild protenuria