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lecture 6 [adolescent + renal] Flashcards

1
Q

what kind of changes are to be expected in the postpubescent period?

A
  • complete skeletal growth
  • well-established reproductive functions
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2
Q

ages

early adolescence

A

11-14

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3
Q

ages

middle adolescence

A

15-17

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4
Q

ages

late adolescence

A

18-20

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5
Q

which gland is responsible for the development of secondary sex characteristics?

A

anterior pituitary gland

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6
Q

which part of the brain stimulates the anterior pituitary gland?

A

hypothalamus

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7
Q

what stage of Erikson’s are adolescents in?

A

group identity vs. alienation

Stage 5

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8
Q

what is the nurse’s role regarding parents & adolescents?

A

facilitator between their discussions without taking any sides

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9
Q

what stage of Piaget’s developmental thought processes are adolescents in?

A

formal operational (abstract & hypothetical thinking)

stage 4

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10
Q

what are the characteristics of thought processes that adolescents have developed?

(4)

A
  • mental manipulation of 2 or more variables simultaneously
  • hypothetical thinking
  • scientific & formal logic
  • higher ability to “stand in someone’s shoes”
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11
Q

how does an adolescent’s relationship with their parents change?

A

mutual affection & equality

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12
Q

adolescents begin to develop sexual orientation & identification during this stage

A

true

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13
Q

what are the nursing implications for an adolescent’s developing sexuality?

A

present sex-ed in a straightforward manner

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14
Q

caloric needs & protein requirements are higher at this stage than others

A

true

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15
Q

what is the most common nutritional disturbance & challenging health problem of adolescents?

A

obesity

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16
Q

what is the likelihood of obese adolescents to become obese adults?

A

70-80%

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17
Q

most adolescents who have disturbed sleeping patterns tend to describe themselves negatively

A

true

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18
Q

what are common sleep disturbances among adolescents?

(4)

A
  • difficulty waking
  • sleepiness during the day
  • frequent periods of wakefulness in the middle of the night
  • difficulty going to sleep
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19
Q

at what age do girls start getting the HPV vaccine?

A

9 yrs old

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20
Q

how many weeks apart are Varicella doses for children younger than 13 yrs old?

A

3 months

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21
Q

how many weeks apart are Varicella doses for children older than 13 yrs old?

A

4 weeks

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22
Q

what are the various external defects of the genitourinary system among adolescents?

(9)

A
  • inguinal hernia
  • hydrocele
  • phimosis
  • hypospadias
  • chordee
  • epispadias
  • cryptorchidism
  • bladder exstrophy
  • ambiguous genitalia
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23
Q

when does surgery happen for GU defects?

A

before preschool

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24
Q

nurses need to be conscious of how children view genital surgery–it may be a “punishment” & become obsessed with what is “normal”

A

true

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25
# definition inguinal hernia
protrusion of ABD contents into scrotum
26
# definition phimosis
narrowed opening of foreskin
27
# definition chordee
ventral curvature
28
# definition cryptorchidism
undscended testes
29
# definition bladder exstrophy
bladder develops outside of exterior ABD wall
30
what is the pathophysiology of *obstructive uropathy*?
hydronephrosis causing distal nephron damage leading to urine concentration
31
what is the nursing care for *obstructive uropathy*? | (4)
* potential discharge w/ equipment *(urostomy, kidney drains)* * present options for dialysis or transplant * increase fluid * monitor for sediments
32
what are some *GU dysfunctions* commonly seen among children? | (9)
* UTI * vesicoureteral reflux * obstructive uropathy * nephrotic syndrome * acute glomerulonephritis * hemolytic uremic syndrome * Wilms Tumor * AKI * CKD
33
what are the types of *UTI*? | (2)
* cystitis *(bladder)* * pyelonephritis *(kidney)*
34
what are the risk factors for *UTI*? | (5)
* uncircumcised males under 3 months * short urethera in females * urine stasis * malformation of another system *(i.e. low-set ears or ear tags)* * renal reflux or malformation
35
why are ear malformations considered a risk factor for *UTI*?
the ears & kidneys were developing simultaneously in-utero
36
what is the nursing care for *UTI*?
* increase fluid intake *(for flushing)* * cranberry juice *(sugar-free)*
37
what are the s/s of *UTI*?
* decreased appetite * ***back pain*** * polyuria * polydipsia * pain w/ voiding * hematuria * fatigue * abd pain
38
pathophysiology of *vesicoureteral reflux*
cytitis moves to pyelonephritis
39
what are the s/s of *vesicoureteral reflux*? | (4)
* residual urine in ureters * high fevers * emesis * chills
40
what are the diagnostic test for *vesicoureteral reflux*? | (2)
* cytoscopy * voiding cystourethrogram
41
what is the nursing care for *vesicoureteral reflux*? | (3)
* prevent bacteria travelling up to kidneys from bladder * low-dose ABX * cultures every 2-3 months
42
what is the pathophysiology of *nephrotic syndrome*?
increasing permeability of basement membrane in kidneys leading to albumin leaks & accumulation of fluid in interstitial spaces
43
what is the etiology of *nephrotic syndrome*?
* proteinuria * hypoalbuminemia * nephrosis * glomerular damage * autosomal recessive
44
what are the manifestations of *nephrotic syndrome*? | (7)
* weight gain * edema * ascites * poor appetite * HTN * tired * proteinuria
45
what is the treatment for *nephrotic syndrome*?
* low Na+ diet * severe fluid restriction * diuretics *(due to edema)* * 25% albumin * steroids
46
what is the goal for treating *nephrotic syndrome*?
* reduce excretion of urinary protein * reduce fluid retention in tissues * prevent infection
47
which conditions does *glomerulonephritis* usually precede?
* pneumococcal infections * streptococcal infections
48
how long is the *latent period* for *glomerulonephritis* preceding certain viral & bacterial infections?
10 days
49
what is the nursing care for *glumerulonephritis* with BP WNL?
teach home management
50
what is the nursing care *glomerulonephritis* in the hospital?
* strict Na+ restriction * daily wt * seizure precautions *(indicated for pt w/ edema & hematuria)*
51
what is an indication for improving *glomerulonephritis*?
increasing C3 levels
52
what is the role of *C3 factors* in the immune system?
activates the *complement system* in which antibodies are more effective in eliminating microbes
53
what is the pathophysiology of *hemolytic uremic syndrome*?
endothelial lining of glomerular arterioles swell & are occluded due to plt & clot deposits causing damage to RBCs and their elimination by the spleen
54
what is the triad for *HUS*?
* anemia * thrombocytopenia * renal failure
55
what are the manifestations of *HUS*?
* acuired hemolytic anemia * thrombocytopenia * renal injury * CNS changes * E. coli infection
56
what is the treatment for *HUS*? | (3)
* hemodialysis * FFP *(fresh frozen plasma)* * plasmapheresis
57
complications of *HUS* | (3)
* chronic renal failure * HTN * CNS disorders
58
another name for *Wilms Tumor*
nephroblastoma
59
*Wilms tumor* typically affects the left kidney
true
60
*Wilms tumor* predominantly affects black children
true
61
manifestations of *Wilms tumor*
* aniridia * hemihypertrophy * overgrowth syndrome *(Beckwith-Wiedemann)*
62
diagnostic procedures for *Wilms tumor*
* radiographic studies *(x-ray)* * ABD U/S * hematologic & biochem studies * UA
63
why should nurses not palpate the protrusion in *Wilms tumor*?
to avoid rupturing the tumor
64
what is the treatment for *Wilms tumor*?
surgical removal of tumor, affected kidney, & adjacent adrenal gland
65
what is the etiology of *AKI*?
* decreased perfusion * kidney disease
66
what are the implications for *AKI*?
* azotemia * uremia * inability to excrete waste, concentrate urine, & conserve electrolytes
67
# definition azotemia
accumulation of nitrogenous waste in blood
68
# definition uremia
retention of nitrogenous products in the blood
69
diagnostic results for *AKI*
* elevated BUN * reduced GFR * elevated creatinine
70
manifestations for *AKI*
* oliguria * diuresis
71
what type of precautions need to be considered for *AKI*?
* seizure * cardiac failure
72
treatment for ***oliguric*** *AKI*
avoid Na+, Cl, K+
73
treatment for ***hyperkalemic*** *AKI*
Kayexalate
74
treatment for ***hypertensive*** *AKI*
* anti-HTN * limit fluids * limit salt
75
treatment for ***anemic*** *AKI*
PRBC | if Hgb is < 6g/dL
76
pathophysiology of *chronic kidney injury*
damaged nephrons leading to inability to maintain fluid & electrolyte balance
77
common s/s of *CKI*
* fatigue * pallor * HA * HTN * nausea * cramps * CNS changes
78
diet management for *CKD*
* high carbs * high Ca * limit fresh produce & fruits * low protein * low K+, Na+, P * unrestricted fat intake
79
supplements for *CKD* | (5)
* folate * iron * water-soluble vitamins *(Vit B & C)* * Vit D * phosphorus binding agents *(Ca carbonate & aluminum hydroxide)*
80
complications of *CKD*
* anemia * HTN * infection
81
which condition is *dialysis* only indicated for?
ESRD

PEDS (11 decks)

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