Most common cause of UTI?
S/S of UTI in infants and children under two y/o?
NON-SPECIFIC FTT Vomiting Feeding problems Abd dist Fever Hypothermia Diaper rash
S/S of UTI in children older than two?
Enuresis Incontinence Foul smelling urine Urgency Frequency Dysuria Fever Chills
S/S of UTI in adolescence?
MORE SPECIFIC Frequency Fever Chills Dysuria
MGMT of UTI?
Eliminate infection Prevent recurrence Prevent systemic spread Preserve renal FXN
A 2 y/o comes to the clinic for a well-baby checkup. The RN suspects a UTI based on the following sxs (select all that apply) A. Poor Feeding B. Enuresis C. Back Pain D. Fever E. Vomiting
A D E
How should a clean catch urine specimen be taken from a young girl?
Child should sit on toilet facing the tank
Girls between what ages are considered HIGH-RISK groups for UTI?
Which of the following urine tests of renal function is used to estimate glomerular filtration? A. pH B. Creatinine C. Osmolality D. Protein level
A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually results in: A. incontinence. B. urinary obstruction. C. Recurrent urinary tract infections. D. infarction of renal vessels
Which of the following best describes the cause of most cases of acute glomerulonephritis? A. Renal vascular anomalies B. Antecedent streptococcal infection C. Results from a urinary tract infection D. Structural anomalies of genitourinary tract
In acute glomerulonephritis, the nurse is aware that an early warning sign of encephalopathy is which of the following? A. Seizures B. Psychosis C. Dizziness D. Transient loss of vision
The clinical manifestations of nephrotic syndrome include which of the following? A. Hematuria, bacteriuria, weight gain B. Gross hematuria, albuminuria, fever C. Hypertension, weight loss, proteinuria D. Proteinuria, hypoalbuminemia, edema
Therapeutic management of nephrotic syndrome includes which of the following? A. Corticosteroids B. Long-term diuretics C. Antihypertensive agents D. Fluid and salt restrictions
A 1. Most children with nephrotic syndrome respond to corticosteroids, making this group the drug of choice. Corticosteroid therapy is begun as soon as the diagnosis has been determined. 2. Children with nephrotic syndrome usually do not respond to diuretics. Furosemide, in combination with metolazone, is useful for severe edema. 3. Antihypertensive agents are not indicated in the management. 4. Fluids are rarely restricted. The child is placed on a no-added-salt diet.
Dialysis or transplantation becomes necessary for chronic renal failure when: A. anemia develops. B. acidosis develops. C. glomerular filtration rate falls below 50% of normal. D. Glomerular filtration rate falls below 10% to 15% of normal.
D 4. TX with dialysis or transplantation is required when the glomerular filtration rate falls below 10% to 15% of normal. 1, 2. Anemia and acidosis may be present as part of the underlying disorder. The glomerular filtration rate determines the need for dialysis. 3. The kidneys are able to maintain the chemical composition of fluids within normal limits until more than 50% of functional renal capacity is destroyed by disease or injury.
Which of the following is an advantage of continuous cycling peritoneal dialysis or continuous ambulatory peritoneal dialysis for adolescents who require dialysis? A. Dietary restrictions are no longer necessary. B. Hospitalization is only required several nights per week. C. Adolescents can carry out procedures themselves. D. Insertion of a catheter does not require surgical placement.
Which of the following is the primary clinical manifestation of acute renal failure? A. Oliguria B. Hematuria C. Proteinuria D. Bacteriuria
A 1. Oliguria is the primary clinical symptom of acute renal failure. Generally, urinary output is less than 1 ml/kg/hr. 2. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary manifestations of acute renal failure. 3. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary manifestations of acute renal failure. 4. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary
Common features of acute glomerulonephritis are?
oliguria, edema, HTN, circulatory congestion, hematuria, and proteinuria
Most common of the noninfectious renal diseases in childhood, it is easiest to identify cause with this disease?
APSGN primarily affects who? Peak age of onset?
Schoolage children 6-7 y/o
When do sxs of AGN occur?
10-14 days after infection
C/M of AGN?
Good health till infection Periorbital edema Anorexia Cola-colored urine Decreased urine o/p Mild-moderate HTN Pale, irritable, lethargic H/A, abd discomfort, dysuria
DX evaluation of AGN?
Hematuria, proteinuria, increased spec gravity Discolored urine, RBC, WBC, C&S negative Elevated BUN/Creatinine Serum lytes WNL
MASSIVE proteinuria occurs with?
The MAJOR complications of AGN include?
HTN encephalopathy Acute cardiac decompensation Acute renal failure
Primary signs of encephalopathy?
H/A Dizziness Abd discomfort Vomiting
Progression of encephalopathy causes what S/S?
Transient loss of vision Hemiparesis Disorientation Generalized Tonic-Clonic Seizures
Most common presentation of glomerular injury in children?
What are the 3 types of nephrotic syndrome?
PRIMARY - restricted to glomerular injury SECONDARY - develops as part of a systemic illness. (drug toxicity, AIDS, Sickle cell, GN, TB) CONGENITAL - Recessive gene, infants are small for gestational age) - require transplant
NURSING MGMT of nephrotic syndrome?
BR with edema TX infection Low salt diet Corticosteroids Diuretics I&O & Daily Wt Examine urine for albumin Abd measurements
Most common presenting sx of Wilm's tumor?
PAINLESS swelling or mass within abd mass is: - Firm - Nontender - Confined to one side - Deep w/in flank)
RARE in adolescents but usually malignant
Hard painless mass, smooth or nodular
TX: orchiectomy, chemo and radiation
The most common solid tumor in males 15 to 34 years of age is?
SX of UTI often observed in children over age 2 years include: (Select all that apply)
A. incontinence in a child previously toilet trained
B. abd pain
C. strong or foul odor to the urine
D. frequency of urination
A, B, C, D