T3 U7 RENAL

Question 1

Main symptom when the kidneys are off balance

Answer 1

HTN

Question 2

A child is admitted with AKI post severe dehydration, what common complication of AKI in pedi?

Answer 2

HTN

Question 3

what common finding is often related to AKI in symptom presentation?

Answer 3

HA (r/t dehydration & kidney filtration)

Question 4

What is the most important intervention with AKI?

Answer 4

Monitoring I&O’s

Question 5

what happens to calcium in AKI?

Answer 5

HYPOcalcemia

Question 6

what is the best test to run to assess kidney function in children with AKI?

Answer 6

Serum creatinine

Question 7

what diet should AKI patients follow?

Answer 7

Low in K
Low in salt
Low in phosporus
High in Ca

Question 8

examples of food to avoid in AKI?

Answer 8

Oranges
Beans
Dairy
Lunch meat
Dark Soda

Question 9

when receiving hemodialysis for AKI, what should the nurse do during the procedure?

Answer 9

Assess for s/sx of infection at access site

Question 10

what is most likely to be present in a child’s medical Hx that has hemolytic uremic syndrome?

Answer 10

Recent Gastrointestinal infection with bloody diarrhea (E. Coli)

Question 11

what lab finding(S) would be expected in a child with hemolytic uremic syndrome?

Answer 11

elevated BUN & creatinine
hyperkalemia

Question 12

what would be the priority intervention for a child diagnosed with hemolytic uremic syndrome?

Answer 12

administering IV fluids

Question 13

what would the nurse assess on a patient at risk for fluid overload that has hemolytic uremic syndrome?

Answer 13

crackles heard on lung ausculation

Question 14

why do children the HUS sometimes receive a blood transfusion?

Answer 14

needed to replace red blood cells that have been destroyed

Question 15

what would be characteristic of nephrotic syndrome?

Answer 15

proteinuria
(foamy urine)

Question 16

what should the diet of a PT with nephrotic syndrome look like?

Answer 16

Low sodium

Question 17

a child with nephrotic syndrome is on corticosteroids, which side effect is most important to monitor & why?

Answer 17

increased susceptibility to infection
bc longterm steroids = decreased immune system

Question 18

how can a childs abdomen present with nephrotic syndrome?

Answer 18

Ascites, distended

Question 19

when assess a PT with nephrotic syndrome, what would indicate theyre responding to treatment well?

Answer 19

Decreased abdominal girth

Question 20

what med would be appropriate for treating enuresis

Answer 20

Oxybutynin Chloride (Ditropan) - 5mg/day

Question 21

normal serum albumin level?

Answer 21

4.5-9

Question 22

4 main complications associated with hemodialysis?

Answer 22

HypoT
bleeding
febrile reaction
infection

Question 23

why do we prescribe Tums (Ca carbonate) to AKI patients?

Answer 23

Gets rid of high levels of phosphrous

Question 24

if a cross country runner has a urinalysis during school physical & presents with proteinuria, which action is most appropiate?

Answer 24

redo test in 48 hr

Question 25

s/sx of kidney transplant rejection?

Answer 25

Pain over kidney Fever decreased urinary output edema

Question 26

what test/sign being positive for a child with stomach pain require immediate intervention?

Answer 26

Positive heel drop jarring test (APPDX)

Question 27

a PT with glomerulonephritis was prescribed corticosteroids, what should the nurse monitor?

Answer 27

Blood glucose

Question 28

regarding exercise & glomerulonephritis, what would be an incorrect statement?

Answer 28

Can resume normal exercise routine without any restrictions

Question 29

what lab level would be priority in a PT with end stage renal disease thats receiving hemodialysis? & why

Answer 29

serum potassium level High can cause cardiac arrest = kill you faster

Question 30

what food choice would adhere to a low phosph diet?

Answer 30

whole wheat bread

Question 31

A renal disease PT on a loop diurertic (Furosemide) should be have what monitored?

Answer 31

BP & Vit K

Question 32

why shouldnt a PT with chronic renal failure take OTC pain meds

Answer 32

likely on corticosteroids & NSAIDS interferre

Question 33

what would the nurse associated with primary enuresis?

Answer 33

bedwetting that has been present since early childhood w/o periods of dryness

Question 34

s/sx of UTI

Answer 34

Fever Malodorus urine dribbling urine dysuria flank pain

Question 35

what would be present in a urine analysis for a UTI?

Answer 35

Nitrates (PINK)

Question 36

prevention edu for UTI?

Answer 36

handwashing wipe front to back cotton underwear & loosefitting clothes Avoid bubblebaths & sitting in swimswear for long periods

Question 37

diff btwn primary & secondary VUR?

Answer 37

P: Congenital S: Infection/obstruction

Question 38

s/sx of VUR

Answer 38

UTI s/sx Enuresis Fever Enlarged kidneys on imaging

Question 39

is VUR r/t hematuria?

Answer 39

NO

Question 40

s/sx of pyelonephritis

Answer 40

high fever painful/frequent urination cloudy/foul smelling urine

Question 41

pathology of acute glomerulonephritis?

Answer 41

occlusion of glomerular capillaries = decreased urine filtration water & Na retention --> circulatory congestion & HTN

Question 42

what infection does acute glomerulonephritis often follow?

Answer 42

Strep or impetigo

Question 43

s/sx of acute glomerulonephritis

Answer 43

gross hematuria (bloody urine) periorbital edema HTN HA

Question 44

what is the diagnosis for acute glomerulonephritis

Answer 44

ASO titer (detect prior strep)

Question 45

management for acute glomerulonephritis

Answer 45

strict I&O (same scale/time) ABX Diuretics (monitor BP) Low sodium

Question 46

Hemolytic Uremic Syndrome (HUS)

Answer 46

Acute renal failure r/t ingesting E.Coli (undercooked beef)

Question 47

staple symptoms of HUS

Answer 47

Bloody diarrhea (Gastroenteritis)

Question 48

s/sx of HUS

Answer 48

Bloody diarrhea Hematuria & proteinuria Pallor Altered LOC

Question 49

prevention HUS

Answer 49

fully cook beef wash fruits/veggies use pasteurized products

Question 50

lab diagnosis for HUS

Answer 50

Elevated BUN + Creatinine High K High Phos Low Ca

Question 51

what to monitor for with HUS

Answer 51

Potential for dialysis LOC/ICP I&O (CHF)

Question 52

Nephrotic syndrome can lead to what? (4)

Answer 52

HYPOalbuminemia Proteinuria Hyperlipidemia Hypercholesterolemia Edema

Question 53

s/sx of Nephrotic syndrome?

Answer 53

severe edema (periorbital) Anorexia massive proteinuria

Question 54

AKI leads to what being imbalance?

Answer 54

A/B balance Fluid balance Electrolyte

Question 55

what are the 3 main causes (general) of AKI?

Answer 55

Pre-renal Intrarenal Postrenal

Question 56

examples of pre-renal causes of AKI?

Answer 56

Effect profusion Hypovolemia Cardiac failure Dehydration

Question 57

ex of intrarenal causes of AKI?

Answer 57

Infection Glomerulonephritis NSAIDS

Question 58

Ex of post renal causes of AKI

Answer 58

Obstructions Stones Tumor Clots

Question 59

what labs would be indicative of AKI

Answer 59

HYPErphos HYPOcal HYPERkal

Question 60

what physiolgical changes can happen with hyperkalemia

Answer 60

weird EKG TachyC, Kussmals breathing

Question 61

what counseling is recommended for Chronic kidney disease PT?

Answer 61

genetic

Question 62

chronic kidney disease diet?

Answer 62

low/mod protein low sodium low potassium low phosp

Question 63

ex what cant be of CKD diet

Answer 63

NO bananas dairy red meat salty

Question 64

what facial feature assessment can indicate potential kidney issues?

Answer 64

ears ask about hearing impairment

Question 65

what is peritoneal dialysis?

Answer 65

Dialysis + ABD cath + osmotic process + drain

Question 66

what finding should the nurse immediately report with Continuous cycling dialysis?

Answer 66

Cloudy dialysate

Question 67

2 major complications from peritoneal dialysis?

Answer 67

Peritonitis Pulmonary complications

Question 68

how to treat Peritonitis

Answer 68

Cephalosporins/vanco

Question 69

what would be the next step if a peritoneal pt reported pain?

Answer 69

Slow down rate

Question 70

what does the nurse check to ensure P.Dialysis is safe to start?

Answer 70

I&O Labs V/S

Question 71

frequency of hemodialysis

Answer 71

3/4x week for 3-4 hr

Question 72

what is used for hemodialysis for access?

Answer 72

AV fistula

Question 73

after AV Fistula is placed, what is the next step for hemodialysis?

Answer 73

wait 2-6wk for AVF to become stronger

Question 74

what should the nurse note about the AVF?

Answer 74

Bruit is heard over AVF @ incision

Question 75

complications of hemodialysis

Answer 75

HYPOT HYPOvolemia Anemia muscle cramps

Question 76

what electrolyes should be monitored with hemodialysis

Answer 76

K (!!) Na

Question 77

what foods should a hemodialysis pt avoid?

Answer 77

bananas/spinach lunch meat/dark soda

Question 78

how might a pt with enuresis present?

Answer 78

urgency - jiggling/crossing legs foul smelling urine Polyuria (Diabetes)

Question 79

med management of enuresis

Answer 79

DDVAP (Desmopressin) Nasal Spray

Question 80

Considerations for DDVAP?

Answer 80

Not used for under 6Y Risk of low Na If HTN = use PO

Question 81

interventions for enuresis

Answer 81

voiding all fluids bed/bladder alarm

Question 82

edu for bed/bladder alarm?

Answer 82

stop all liquids before bed go pee again after in bed for 20 min

Question 83

what is hypospadias?

Answer 83

urethral opening located on underside of penis

Question 84

manifestations for hypospadias?

Answer 84

incomplete foreskin curve during erection abnormal scrotal position

Question 85

why dont you preform circumcision on a hypospadias PT?

Answer 85

the skin is used to fix defect in surgery

Question 86

what to report immediately if found in Post op with hypospadias?

Answer 86

Blood in foley bag