clues to renal disorders on prenatal US?
bedwetting in a child who has never had voluntary bladder control
bedwetting in a child with previous control over bladder
mgmt of enuresis?
- ^ fluids during day, restrict before bedtime
- routine schedule
- education and support
- oral/nasal spray antidiuretic
- not given <6 years
DDAVP, oxybutynin or imipramide?
enuresis pharm therapies
most common cause of UTI?
most common bacterial infx in children?
why is UTI more common in infants/children than older?
s/sx of UTIs?
fever, jaundice, poor eating, weight loss
- backward urine flow from bladder to ureters to renal pelvis
- common in kids with UTI
long term complications from vesicoureteral reflux?
nursing mgmt of vesicoureteral reflux?
prophylaxis abx, surgical correction, follow up VCUG
abnormalities in urinary system that interfere with urine flow
accumulation of urine in renal pelvis due to obstructed outflow of urine
post urethral valve
- obstruction that blocks urethra
- clinical emergency
- urine backs up and can cause permanent kidney damage
ureters disconnected from bladder, reattached to ileum
normal descent of testes when?
7th - 9th month of gestation
if undescended testes is not corrected, increased risk for..?
- hypo - urethral opening on top of penis
- epispadias - urethral opening underneath penis
contraindication for hypospadias/epispadias?
neonatal circumcision. skin may be used for reconstruction
acute post-streptococcal glomerulonephritis occurs when?
1-2 weeks after a strep infection
most common childhood renal disease? peak age?
- AGN (acute post-strep glomerulonephritis)
- age 5-7
pathophys of AGN?
complex of antigen-antibody is lodged in glomeruli. inflammatory response, reduced renal function.
how to diagnose AGN?
- throat culture
- *look for elevated antibody titer (antistreptolysin O)
- * elevated erythrocyte sedimentation
- ^ BUN/crt
important to monitor during AGN?
BP! hypertension common compx
complications of AGN
- ◦ Severe hypertension *
- ◦ Hypertensive encephalopathy*
- ◦ Seizures*
- ◦ Cardiac decompensation from hypervolemia*
- ◦ Acute renal failure*
- autoimmune process 1 wk after immune response
- permeability of membrane is changed (letting more thru).
- proteins spilling into urine
albumin levels secondary to nephrotic syndrome?
very low. (losing protein)
hypoalbumenia, proteinuria, hyperlipidemia.. indicators of what?
why so much edema with nephrotic syndrome?
- third spacing.
- intravascular fluid -> interstitial space > hypovolemia
pharm treatment for nephrotic sydnrome?