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NUR 440 Exam 3 > Renal Disorders > Flashcards

Renal Disorders Flashcards

1
Q

Bladder Capacity- Newborn

A

1 to 2 oz

1 oz = 30cc

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2
Q

Bladder Capacity- Child

A

Age (in years) + 2 = oz

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3
Q

Phimosis

A

Narrowing or stenosis of the opening of the foreskin
Normal in infants and young boys
Can obstruct flow

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4
Q

Phimosis Nursing Care

A

Thorough and consistent hygiene
DO NOT forcibly retract foreskin– PARAPHIMOSIS
Worry about infection

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5
Q

Phimosis Treatment

A

Circumcision

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6
Q

Hydrocele

A

Fluid filled sac around a testicle, scrotal swelling
Non-communicating - Common in newborns, resolves on own
Communicating - Surgical repair

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7
Q

Hydrocele Nursing Care

A

Instruct parents that most resolve spontaneously

Continue to watch

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8
Q

Hypospadias

A

Urethral opening is located below the glans penis or anywhere on the ventral surface

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9
Q

Hypospadias Nursing Care

A

Inspect all male newborns
Teach parents post operative care - indwelling catheters, stents, irrigation
I/O’s

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10
Q

Hypospadias Goals

A

Enable normal voiding

Preserve sexual functioning

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11
Q

Ambiguous Genitalia

A

Disturbance of normal events of gender determination
Abnormal gender determination, differentiation of gonads, differentiation of ductal systems, abnormal secretion of androgen or tissue insensitivity to hormone

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12
Q

Ambiguous Genitalia Nursing Care

A

Support parents in participation with health care team to make a gender assignment
Assist parents in understanding the process and importance of careful assignment
Assignment does not need to happen immediately

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13
Q

Vesicoureteral Reflux

A

Retrograde flow of urine from the bladder into the ureter
Most common cause: pyelonephritis
Girls > Boys
HIGH RISK FOR INFECTION

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14
Q

Vesicoureteral Reflux- Primary

A

Congenital
Abnormal tunneling of urethral segment or defects in ureter orifice
More common amount siblings

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15
Q

Vesicoureteral Reflux- Secondary

A

Acquired
UTI or trauma can produce temporary reflux
Multiple infections before 3- be suspicious

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16
Q

Vesicoureteral Reflux Grades

A

Full bladder – refluxes back up in ureter
Grade 1 &2 – Can resolve on its own
Grade 4&5 – Surgical Interventions

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17
Q

Vesicoureteral Reflux Nursing Care

A

Goal is to prevent infection and scarring
Support parents in adherence to medication
Chronic antibiotics
Frequent evaluation of urine

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18
Q

Obstruction of Uropathy Symptoms

A 
UTI
Hematuria
Nausea
Flank pain
Dysfunctional voiding patterns
Can happen anywhere in the tract
Urinary stasis is the biggest risk
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19
Q

Upper Tract Urinary Infection

A

Ureter
Renal Pelvis
Calyces
Renal parenchyma

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20
Q

Lower Tract Urinary Infection

A

Urethra

Bladder

21
Q

Risk Factors for UTI

A

Urinary stasis - biggest risk
Children 2-6 – potty training age!
Girls

22
Q

Recurrent UTI

A

Repeated episodes of bacteriuria

23
Q

Persistent UTI

A

Despite antibiotics treatment, bacteria persits

24
Q

Febrile UTI

A

Bacteria with fever, implies pyelonephritis

Infants- common UTI with fever

25
Q

Urethritis

A

Inflammation of the urethra

26
Q

Urosepsis

A

Systemic signs of bacterial illness with UTI

27
Q

Pyelonephritis

A

Inflammation of the UPPER urinary tract AND kidney

28
Q

Cystitis

A

Inflammation of the bladder

29
Q

UTI Nursing Care

A

PREVENTION
Proper voiding technique, avoid tight clothing and diapers, encourage generous fluid intake, avoid constipation, avoid “holding” urine

30
Q

UTI Symptoms

A

Educate parents! Signs: incontinence in a toilet trained child, strong smelling urine, frequency and urgency, pain

31
Q

Acute Glomerulonephritis (AGN)

A

A post- infection, immune complex condition associated with a combination of symptoms
SECONDARY
Glomerular capillaries are injured = decrease GFR

32
Q

AGN Symptoms

A

OLIGURIA
EDEMA
HTN
Circulatory congestion - puffy eyes, hematuria, proteinura, loss of appetite, cola colored urine, irritable, lethargic

33
Q

AGN Timeline

A 
Staph infection
10days - 2 weeks
Then symptomatic 
Edema resolves- AGN starting to resolve 
10 days - 3 weeks acute phase followed by DIURESIS phase
34
Q

AGN Complications

A

Hypertensive encephalopathy and cerebral edema
Acute cardiac de-compensation- from HTN
Acute renal failure
Na and Water retention issues

35
Q

AGN Nursing Care

A

Closely monitor VS, fluid balance, and childs appearance
Daily weight is best!
Assess irritability, change in LOC, HTN
Assess early renal failure – hyperkalemia, uremia, excessive BUN, elevated creatinine, metabolic acidosis

36
Q

Nephrotic Syndrome

A

A number of distinct glomerular diseases with increased glomerular permeability = massive proteinuria, hypoalbuminemia, hyperlipidemia and EDEMA
MASSIVE PROTEIN IN URINE- “Dumping”
Leak fluid into tissues- vascular protein decreases

37
Q

Types of Nephrotic Syndrome

A

Minimal changes - 80%, biposy looks normal. Resolves
Secondary – result of AGN
Congenital – Autosomal recessive genetic disorder

38
Q

Nephrotic Syndrome Nursing Care

A 
Strict daily weights, VS, I/O's
Measure abdominal girth, urine output, color and appearance of protein 
Meticulous skin care- look at folds!
Preventive measures to avoid infections
Monitor for spontaneous peritonitis 
Good nutrition and meal planning!
Developmental and family support
39
Q

Acute Renal Failure

A

Sudden inability of the kidneys to regulate volume and composition of urine
Oliguria, azotemia, acidosis, diverse electrolyte imbalances
DEHYDRATION! Secondary to vomiting or diarrhea
TX: Dialysis, Na balance

40
Q

Enuresis

A

Intentional or involuntary passage of urine into the bed during sleep or into clothing during daytime hours at least twice a week for 3 months in children at least 5 years of age
Usually resolves between ages 6 and 8

41
Q

Enuresis: Primary

A

Never achieved continence

42
Q

Enuresis: Secondary

A

Onset of wetting after having achieved continence

Infection, physiologic reason, psychological , a significant event

43
Q

Enuresis: Causes

A

Urinary tract infection that is undetected
Genetic predisposition
Familial tendency
Emotional or behavioral factors

44
Q

Enuresis: Nursing Care

A

Assess for physiologic cause
Support and respect the child and parents
Support treatment plans (audible alarms, medications, behavioral therapies)
Help child manage treatment expectations and provide consistency in the process
Provide reassurance to parents
Medication to decrease bladder spasms

45
Q

Encopresis

A

Repeated voluntary or involuntary passage of feces of normal or near normal consistency in inappropriate places at least once per month for 3 months after the age of 4 years
CONSTIPATION

46
Q

Encopresis: Primary

A

Never achieved continence

47
Q

Encopresis: Secondary

A

Happens after established fecal continence

Painful to have a BM– further avoidance

48
Q

Encopresis: Etiology

A

Constipation due to stressors in the environment and withholding stool
Chronic and severe constipation resulting in fecal obstruction
Abnormalities of the digestive tract (rectal prolapse)
Medical conditions [CP, MD, irritable bowel syndrome (IBS)]
Fear-panic disorders leading to learned abnormal defecation patterns

49
Q

Encopresis: Nursing Care

A 
Thorough history and care is directed toward cause of soiling
Education about normal digestive patterns and defecation
Bowel retraining
Correction of impaction
Positive reinforcement
Family plan and follow-up
Support and non-judgmental attitude
At 5 -- suppose to be continent!

NUR 440 Exam 3 (5 decks)

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