What are some lab tests to determine renal function
BUN
Uric acid
Creatine
BUN/CRE ratio
What is the cause of 80% of UTIs?
E. coli (due to wiping back to front)
What are S/S of a UTI
frequent urination
painful urination
s/s of dehydration
foul, concentrated urine
fever
pallor
poor feeding, lethargy
How is a UTI diagnosed
UA
urine culture
what is the best way to obtain a specimen for a urine culture
clean catch (wipe with wipes then void in cup)
How do we treat a UTI
antibiotic therapy
fluid maintenance
collect specimens as ordered
education (prevention)
What is the common peak age for onset for glomerulonephritis?
6-7 years
twice as common among males than females
What is the most common cause of glomerulonephritis?
Group A beta-hemolytic streptococcus (untreated strep goes to blood stream and to kidneys)
If patient comes in with s/s of UTI and they had strep throat a couple of weeks ago, what do you expect?
glomerulonephritis
What are the S/S of glomerulonephritis?
Edema (especially periorbital)
facial edema (more prominent in am)
Urine is cloudy, smoky brown
irritability
lethargy
pallor
mild to moderately elevated BP
How are we going to treat glomerulonephritis?
may have fluid restriction
moderate sodium restriction
restriction of potassium rich foods
may get antibiotics
monitor lab values
What is happening in nephrotic syndrome?
hyperalbuminuria (or proteinuria)
hypoalbuminermia
initially unexplained hyperlipidemia
body fluid balance shift (edema, ascites, hypovolemia)
What are the s/s of nephrotic sydrome
Weight gain
facial edema (bad during am and subsides during the day)
generalized edema
ascites
lethargic, easily fatigued
irritability
BP normal or slightly decreased
frothy urine
may have diarrhea
how are we going to treat nephrotic syndrome
dietary changes (low sodium diet)
meds (corticosteriods and diuretics)
monitor I/O
education
You are a nurse in a pediatric emergency room. Around 5 PM, a 3-yr old child is admitted to your care for lethargy, irritability, decreased urine output, and (per the parents) "looking a little puffy". On your assessment, you note that the patient's "puffiness" (edema) is not significant, but the parents state that it was really bad in the morning.The patient's urine, on inspection, is dark amber-colored but clear, and there really isn't a significant quantity of it. You find that the urine is positive for protein.Vital signs are as follows: HR 136 (normal 80-100), BP 124/85 (normal 90-110/60-70), T 100.1° F. Based on these findings, you suspect that your patient likely has
glomerulonephritis
T or F: If caught early enough, the patient with nephrotic syndrome has a good prognosis for recovery.
True
Your 6 year old patient presents with edema, irritability, and waxy pallor. Mom states that his clothes seem to be getting too tight on him quickly after she buys them. Urinalysis shows a high level of protein and frothy urine. Albumin level is 3.2 g/dL (normal 4-5.8 g/dL for children). B/P is 90/65 (normally 105/70). Your patient is most likely experiencing which of the following?
Nephrotic syndrome
Patients with BPH (Benign Prostatic Hyperplasia)
should be discouraged from taking which of these medications because they can lead to acute urinary retention?
Cold medicines/diphenhydramine
What does not predispose the child to UTIs?
lower urine pH
In a nonpotty-trained child with nephrotic syndrome, the best way to detect fluid retention is to:
weigh the child daily
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse's reply should be based on knowledge that:
Acute hypertension must be anticipated and identified.
Acute glomerulonephritis would most likely be suspected if the child presented with the clinical manifestations of:
Edema, hematuria, and oliguria
The nurse caring for the child with glomerulonephritis would expect to:
weight the child daily
Clinical manifestations of nephrotic syndrome include
hyperlipidemia, hypoalbuminemia, edema and proteinuria
