Peds Exam (5900) #3 > GU dysfunction > Flashcards

GU dysfunction Flashcards

(59 cards)

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1
Q

Common Manifestations of Genitourinary Problems aged birth - 1 month?

A
  • Abnormal voiding patterns (structural or due to urinary tract infection, reflux, obstruction)
  • Poor feeding & failure to gain weight
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2
Q

Common Manifestations of Genitourinary Problems aged 1 month -2 yrs?

A
  • Failure to thrive
  • Fevers
  • Abdominal distention
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3
Q

Common Manifestations of Genitourinary Problems aged 2-14 yrs?

A
  • Delayed toilet training
  • Recurrence of enuresis after toilet training
  • Poor appetite
  • Edema
  • Hypertension
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4
Q

Failure of one or both testes to descend normally through the inguinal canal into the scrotum

A

Cryptorchidism

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5
Q

Cryptorchidism

A

Failure of one or both testes to descend normally through the inguinal canal into the scrotum

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6
Q

Orchiopexy for Cryptorchidism is usually performed at what age?

A

1-2 y/o

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7
Q

Spontaneous descent of the testicle in Cryptorchidism usually occurs at what age?

A

in first year of life

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8
Q

Why would hormone therapy be attempted for Cryptorchidism?

A
  • For bilateral nonpalpable cryptorchidism

- To see if viable testicular tissue is present

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9
Q

Urethral opening of male is located below the glans or underneath the penile shaft

A

Hypospadias

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10
Q

Hypospadias

A

Urethral opening of male is located below the glans or underneath the penile shaft

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11
Q

a ventral curvature of the penis that may accompany hypospadias?

A

chordee

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12
Q

chordee

A

a ventral curvature of the penis that may accompany hypospadias

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13
Q

Surgical repair of a hypospadias is optimally done at what age?

A

6-12 months, no circumcision prior to surgery

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14
Q
  • Short, wide penis with an abnormal curve

- urethra usually opens on the top or side of the penis instead of the tip

A

Epispadius

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15
Q

Epispadius

A
  • Short, wide penis with an abnormal curve

- urethra usually opens on the top or side of the penis instead of the tip

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16
Q

bladder exstrophy

A

rare birth defect where the bladder is inside out and sticks through the abdomen wall

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17
Q

rare birth defect where the bladder is inside out and sticks through the abdomen wall

A

bladder exstrophy

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18
Q

Therapeutic Goals of Epispadias/Exstrophy Management?

A
  • Preserve renal function
  • Attain urinary control
  • Prevent UTIs
  • Preservation of optimum external genitalia with continence and sexual function
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19
Q

Normal antibacterial properties of urinary tract mucosa?

A
  • Acidity of urine
  • Emptying the bladder
  • Peristaltic activity
  • Ureterovesical junction competence
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20
Q

UTI pathogens?

A
  • E. coli
  • Streptococci
  • Staphylococcus saprophysticus
  • Occasionally fungal & parasitic pathogens
  • Common nosocomial infection
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21
Q

Most common cause of UTI?

A

E. coli

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22
Q

UTI: Classification Lower tract

A

Cystitis

Urethritis

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23
Q

UTI: Classification Upper tract

A

Pyelonephritis

Glomerulonephritis

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24
Q

Pediatric patients with significant bacteriuria may have what symptoms?

Study These Flashcards
A

no symptoms or nonspecific symptoms like fatigue, anorexia/poor feeding, changes in bladder habits

25
UTI: Cystitis peak incidence ages?
2-6
26
UTI: Cystitis symptoms?
- Frequency, urgency - Dysuria - Odiferous, cloudy or blood-tinged urine - Reoccurrence of enuresis after toilet-training completed
27
Preferred diagnostic study for Cystitis?
Clean catch
28
Cystitis: Treatment
- Antibiotics - TMP-SMX (Bactrim), Amoxicillin, Nitrofurantoin - Increase oral fluid intake - Provide comfort measures
29
Common causes of Acute Pyelonephritis?
E. coli, Proteus, Klebsiella, Enterobacter
30
Inflammation of the kidney due to infection, usually via ascending urethra route from the bladder?
Acute Pyelonephritis
31
Preexisting factors associated with Acute Pyelonephritis?
- Vesicoureteral reflux | - Obstruction or stricture in lower urinary tract
32
Acute Pyelonephritis: Clinical Manifestations?
- Usually abrupt onset - N/V, anorexia, fever, chills - Nocturia, frequency, urgency, dysuria - Suprapubic or low back pain - Foul-smelling urine, hematuria, WBCs or pus in urine
33
Acute Pyelonephritis: Treatment & Nursing Care?
- Hospitalization - Parenteral (IV) antibiotics - Comfort measures - Imaging studies (IVP or CT), ultrasound may be done
34
the abnormal flow of urine from the bladder to the upper urinary tract.
Vesicoureteral reflux
35
Vesicoureteral reflux
- the abnormal flow of urine from the bladder to the upper urinary tract. - often asymptomatic
36
VUR grade(s) that may resolve on its own during early childhood, so will be monitored
1-3
37
VUR grade that can lead to permanent kidney damage, scarring, hypertension if not corrected because of increased risk of pyelonephritis
4-5
38
an x-ray image of the bladder and urethra taken during voiding. The bladder and urethra are filled with a special dye, called contrast medium, to make the urethra clearly visible.
Voiding cystourethrogram (VCUG).
39
Most common type of Glomerulonephritis in children?
is Acute Post-streptococcal Glomerulonephritis (APSG)
40
term used to refer to several renal diseases (usually affecting both kidneys), characterized by inflammation of the the glomerulai or small blood vessels in kidneys?
Glomerulonephritis
41
Onset of Acute Post-Streptococcal Glomerulonephritis (APSGN)?
5-12 days after Group A beta-hemolytic strep infection (strep throat most common)
42
most common APSGN?
strep throat
43
APSGN is most common in what age group?
- children 6-7 years old, but can occur at any age | - males > females,
44
Clinical Presentation of APSGN?
- Generalized edema due to decreased glomerular filtration - Perioribital and facial edema first noted, especially in a.m. - HTN due to increased ECF (mild to moderate) - Oliguria - Hematuria (COLA-COLORED) - Proteinuria
45
APSGN: Management & Nursing Care
- Manage edema - Daily weights & abdominal girth - Accurate I & O - Nutrition - No salt added diet, low to moderate protein - Monitor BP (may need diuretics) - Bedrest is not necessary - Antibiotic therapy if NOT treated previously
46
occurs when glomerular membrane becomes permeable to proteins, especially albumin
Nephrotic Syndrome
47
Most common type of Nephrotic Syndrome in children?
Minimal Change Nephrotic Syndrome (MCNS)
48
Peak incidence of MCNS?
2-7 years of age
49
S/S of MCNS?
- Proteinuria (massive) - Hypoalbuminemia - Edema & weight gain - Hyperlipidemia - Irritability, fatigue, pallor - BP either WNL or slightly increased
50
MCNS: Management & Nursing Care (edema)?
- Daily weights and abdominal girth - Accurate I & O - Diuretics, albumin helpful in some cases
51
MCNS: Management & Nursing Care (nutrition)?
- Ensure adequate fluid intake - void caffeine - Moderate protein - Sodium restrictions if large amt. of edema
52
Drug of choice of MCNS?
Prednisone
53
Potential AE's of steroids?
increased appetite, increased BP, changes in appearance, delayed growth, risk for infection
54
Treatment of choice for MNCS if child is not responding to steroid therapy?
Immunosuppressant therapy (Cytoxan)
55
Prerenal causes of AKI usually seen in pediatric patient related to?
dehydration
56
Acute kidney injury lab findings?
- elevated blood urea nitrogen and creatinine | - inability of the kidneys to produce sufficient amounts of urine.
57
Potential causes of CRF in pediatric patient:
- Congenital renal & urinary tract malformations - VUR associated with recurrent UTIs - Chronic pyelonephritis/glomerulonephritis
58
a progressive loss in renal function over a period of months or years
Chronic kidney disease (CKD), a.k.chronic renal disease (CRD)
59
Treatment Goals for the Child with CRF, to prevent or reduce?
- Anemia - Renal osteodystrophy - Infection - Growth retardation
Peds Exam (5900) #3
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