Genitourinary Alterations PEDS

Lower urinary tract infections

Upper UTI

Creates risk for UTI's

S/S of UTI

Bactrim/Septra

Amoxicillin (a cephalosporin)

Nitrofurantoin (Macrobid)

Cefaclor

Analgesics for UTI

teaching about pyridium

Keep hydrated

Important to change wet diaper to prevent

Involuntary voiding

Neurological developmental delay can cause

UTI can cause

Obstruction or small bladder capacity can cause

Small bladder capacity can cause

Chronic renal failure can cause

Polyuria can cause

Constipation can cause

Inorganic causes of enuresis

Coditioning therapy (bed wetting alarm)

Ditropan

Anticholinergic used for enuresis

Adverse reactions to ditropan

Tofranil used for

Antidepressant used for enuresis

Decreases dept of sleep during later part of night

Dry mouth
Nervousness
Insomnia
Changes in personality

Desmopressin (DDAVP) is used for

ncreases water retention and urine concentration in the renal tubules

S/E of desmopressin

Very importantt to determin organic vs inorganic with

Backflow of urin from bladder to ureter to kidey due to uretovesical/vesicuretal junction

Most common defect of GU tract

Evaluate with repeated UTIs, enuresis, flank and or abdominal pain

Diagnosis/Treatment for VUR

Anti-cholinergic used for treatmetn of VUR

Tx of Hypospadias

When should hypospadias be corrected

Should the child be catheterized with hypospadias?

Tx of hypospadias

Should hypospadias clients have a circumsion?

Anticholinergic for hypospadia

Circumcision for epispadias?

Who usually dectes cryptochoridism?

Surgery for cryptochidism

Who has cryptorchidism?

Can testes decend on own?

Sperm count with cryptochidism

Risk for testic cancer

Surgery to lengthan penis and reconstruction of bladder neck

Bulging/swelling in scrotum

May increase in size with crying, straining

Usually not painful

Hernioorhapy

Eversion of bladder through abdominal wall

bladder closure

Pelvic bone separation

Inguinal repair

Creation of urethral sphincter

Reconstructive surgery prn

Urethral opening anywhere on perinium

Collection of peritoneal fluid in crutum, feels tense and not reducible

Hydrolcelectomy

Hydrocele usually resolves in how long?

If hydrocele does not resolve in one year, indicates

Easier to tx ambiguous genitalia if a femal even if

Intrarenal Acute Renal Fialure

Primary source of Acute glomerulonephritis is not...

Viral infection usually seen 2-3 weeks prior to

Systemic or chronic disease that affects teh glomeruli as a disease process

Cuase of bacterial infection that can be seen 2-3 weeks prior to Acute Glomerulonephritis?

Acute Glomerulonephritis usually seen in which sex?

Acute Glomerulonephritis usually peaks at

With damaged glomeruli, what happens

s/s of AGN

Hematuria is ESSENTIAL FOR DX (TEST QUESTION)

Serum complement (c3), usually low in

Streptozyme test for strep in

Culture off primary site of infection for DX of

If culture ofprimary site of infection with AGN is negative or not possible, DX made on...

Renal biopsy may be indicated for diagnosis of

Treatment of AGN depends on

Maintain F & E balance in tx of

Maintain B/P tx of (Antihypertensives)

Diuretics for edema is a treatment for

Strect fluids adn restrict Na and K is treatment for

Maintain skin integrity important in tx of

Family teachin g(diet, fluid restriction, S/S worsening) in treatment of

Excellent prognosis but beware of worsening condition

Grossly bloody urine (Test question)

Increased edema

Lethargy/Activity intolerance, restlessness

Change in respiratory status

Threat to immune system and leads to inflammatory response is evoked

Massive proteinuria and hypoalbuminemia

Level for hypoalbuminemia

Edema and hyperlipemia

Increase in serum cholesterol, triglycerides, hematocrit and platelet

Most common type of nephrotic syndrome in kids

Immune response to glomerulal disease or systemic infection alters glomerular structure

Renal malfunction due to drugs, systemic disease (cancer, liver, lupus, lead poisoining, toxins, HIVR/1 immune reponse or otherh ds causing stress on kidneys)

Reduce proteinuria

Controling edema is a tx for

Preventing infection is an important treatment in

High dose steroids used as a treamtent of

High dose steroids used in nephrotic syndrome for

Side effect of steroids in Nephrotic syndrome

Use diuretics for severe edema in

If using diuretics for severe edema in nephrotic syndrom watch for

Monitor lytes in

Report loss of how much fluid during nephrotic syndrome

Assess edema, dehydration with

How to prevent fluid overload in treatment of nephrotic syndrome

Limit salt

Watch for infection! Important in

Small feedings of high biologic protein such as fish, chicken in small feedings in

Family teaching with nephrotic syndrome

Most frequent cause of ARF in children

Cused by E-coli food poisoning

After viruese and chemicals inavde GI > vomit/diarrhea ? endotoxins damage and occulde blood vessels ? slows blood to kidneys and or any othe rorgan

85% recover however, potential for development of chronic renal vailure

Prodromal means

Initial symptoms of HUS

Renal failure > dec UOP > clots cause hypertension

Throkmbocytopenia (dec. platelests) bleeding, purpural

Anemia > pallor

Hepatosplenomegaly points to dx of

Edema, hypertension, CHF from edema seen in

Pain, Pallor, dehydration, lethargy

N, V, D, Decreased UOP, Altered LOC

Hemo/peritonial dialysis prn if anuric

Kayexalate enema because kidneys can't excrete high K+

Dextrose/TPN

Ca + gluconate or ca+ chloride tx of

Albumin hydroxide gel used because phosphorus increased bind tophos

Tx of

Apresoline or Capoten tx for hypertension with

Bicarbonate use dto treat metabolic acidosis due to kidneys inabilityh to buffer acids in what disease?

CVP (central venous pressure) monitoring with decreased LOC or seizures with what disease?

Packed RBC's or plasma products, tx for

PO feedings when N & V subsides tx of

Increased T wave due to increased Potassium; widened qrs ; block

Monitor for increased ICP/LOC in what genitouriniry disease?

GI/NG to decompress in what GU disease?

Parents usually find something in the abdomen/dressing/bathing of the child

Grows large without pain

Mass may have hematuria, hypertiension, malaise, and fever

Favorable histology: Resmonds to tx and has better prognosis

Unfavorable - Harder to tx/poor prognosis

How to DX Wilm's Tumor

Labs important in Wilm's turmor

Avoid palpatation

Tx depends on histology

Surgical removal of tumor by radical nephrectomy followed by radiation

Acitonomycin D, Vincristine doxorubicin

Radiation may cause scoliosis/spinal defects

Teach to avoid truama to remaining kidney (sports)

Potential for altered growth with radiation and risk for 2nd tumor

Recurrance w/in 6 months of nephrectomy