Assessment findings for Excess Fluid Volume
HTN, crackles, altered electrolytes (lowered), altered mental status, edema
Assessment findings for Pyelonephritis
- Fever, back (flack) pain, failure to thrive, feeding difficulty, systemic symptoms
- Changes urine or voiding
S/S of Nephrotic Syndrome
- Too much protein in urine (proteinuria)
- Exclusively albumin lost in urine; causes profound generalized edema
- Decreased protein in blood (hypoproteinemia)
- Liver produces lipoproteins; causes hyperlipidemia
What causes Glomerulonephritis
Exposure to Group A streptococcus
Patho of Glomerulonephritis
- Exposure to strep
- Inflammation and cellular proliferation of the glomeruli
Therapeutic regimen for VUR low and high grade
- Low ~ Prophylactic antibiotics
- High ~ Surgery
What is used to diagnose VUR and what does it involve?
- Voiding cystourethrogram
- Uses contrast and catheter to monitor urine movement
What is therapeutic regimen for UTI?
- Antibiotics
- Phenazopyridine for symptom management
What is Phenazopyridine and what is its side effect?
- Dye used to numb urinary tract
- Turns urine orange
How do we treat Hemolytic Uremic Syndrome (HUS)?
- Treat symptoms as there is no cure
- Blood transfusions,
- dialysis
- Maintain fluids and electrolytes
- Treat HTN
- Medicine
What is the most common cause of acute renal failure (ARF) in children?
Hemolytic Uremic Syndrome (HUS)
What often follows a bacterial gastroenteritis that releases toxins? (ex: e coli)
Hemolytic Uremic Syndrome (HUS)
What important education is needed for Hemolytic Uremic Syndrome (HUS)
Use clean water sources and completely cook food
What is HUS characterized by?
thrombocytopenia, hemolytic anemia, and acute renal failure
What is the nursing plan of care of nocturnal enuresis?
Fluid restriction, bladder exercises, timed voiding, antidiuretic hormones, tricyclic antidepressants, anticholinergics
What is the nursing plan of care of Hypospadius?
- Assess for chordee (fibrous band causing downward curve of penis)
Should a pt with hypospadius be circumcised at birth and why?
- No, foreskin used for repair in surgery
When does surgical repair of hypospadius occur?
6-12mo
Pyelonephritis treatment and education
- IV antibiotics, increase fluid intake, void more often
- No bubble baths, wipe from front to back
How much urine should an infant produce?
1-3mL/kg/hr
How much urine should a child produce?
1mL/kg/hr
What is Pyelonephritis?
Infection of the kidneys, often caused by upper UTI
What is Nephrotic Syndrome?
Kidney dmg and too much protein in urine (proteinuria)
What is Glomerulonephritis?
Inflammation and cellular proliferation of the glomeruli
