Pediatrics: Chapter 24: Genitourinary Disorders

When does hydrocele typically resolve?

1 year

What is bladder exstrophy?

A complex, rare d/o that occurs early on while a fetus is developing in the womb that causes the bladder to extrude through the lower abdominal wall

What is nephrotic syndrome?

A group of symptoms that indicate damage to the glomeruli and result in the release of too much protein from the body

Once the child has been anuric (without urine) for 24 hrs, or has oliguria with uremia or HTN and seizures, other means extracting waste products from the body are considered. Which of the following are included? A) Hemodialysis B) Peritoneal dialysis C) Continuous hemofiltration D) Urostomy placement E) Kidney transplant evaluation

A) Hemodialysis B) Peritoneal dialysis C) Continuous hemofiltration

Which of the following is NOT a symptom of nephrotic syndrome? A) Polyuria B) Massive proteinuria C) Hypoalbuminemia D) Edema E) Hyperlipidemia

A) Polyuria

Which of the following are true of pediatric renal and urinary function? SATA. A) Reduced GFR B) Unable to concentrate urine C) Lower BUN and creatinine levels D) Lower AST and ALT E) Higher urine output

A) Reduced GFR B) Unable to concentrate urine C) Lower BUN and creatinine levels

A nurse is assessing a child who is receiving peritoneal dialysis and suspects that the child may have peritonitis. Which finding would support the nurse's suspicions? Select all that apply. A) cloudy dialysis fluid B) abdominal pain C) diarrhea D) increased red blood cell count of dialysate outflow E) syncope

A) cloudy dialysis fluid B) abdominal pain

A child is undergoing diagnostic testing for nephrotic syndrome. When reviewing the results of the testing, which of the following would the nurse expect to find? Select all that apply. A) proteinuria B) hypoalbuminemia C) hypercholesterolemia D) hematuria E) neutropenia

A) proteinuria B) hypoalbuminemia C) hypercholesterolemia

A parent brings her son into the clinic for assessment. She states her son has been having cloudy, dark urine for the past few days and isn't eating well. She also mentioned that his eyes appear swollen. What should the nurse be concerned for?

APSGN

The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?

Absence of a thrill

Explain acute vs chronic renal failure.

Acute - abrupt onset and is potentially reversible Chronic - progresses slowly over at least 3 months and can lead to permanent renal failure

What is hemolytic uremic syndome (HUS)?

Acute renal disease characterized by thrombocytopenia, hemolytic anemia, and AKI

Which of the following are imaging studies used for suspected obstruction? SATA. A) MRI B) Intravenous pyelogram (IVP) C) X-ray D) Abdominal CT scan

B) Intravenous pyelogram (IVP) D) Abdominal CT scan

Which of the following is NOT a possible treatment approach to enuresis? A) Bladder exercises B) Timed voiding C) Diuretic hormones D) Anticholinergics E) Tricyclic antidepressants

C) Diuretic hormones Should be given ANTI-diuretics

Pyelonephritis involves which 3 structures? A) Kidneys B) Bladder C) Ureters D) Renal pelvis E) Renal parenchyma

C) Ureters D) Renal pelvis E) Renal parenchyma

Foods like bananas, carrots, nuts and milk should be restricted in which type of renal failure? Why?

Chronic Low in potassium, protein and sodium

Which of the following does NOT cause testicular torsion? A) Excessive mobility of the testes B) Impact injury C) Vigorous activity D) Cold temperature E) Cancer F) Growth spurt

E) Cancer

T/F: There are 2 grades of VUR and 4 types.

FALSE 4 grades (I-IV) 2 types: primary and secondary

T/F: Enuresis only encompasses nocturnal incontinence (bed wetting)

FALSE Can be diurnal (daytime)

T/F: Monitoring I&O, daily weight, edema and abdominal girth daily is not required in mild cases of nephrotic syndrome.

FALSE These actions should be performed in all patients with this syndrome

Which groups are at risk for UTIs?

Females (<12 months) Uncircumsized males (<3 months)

What is hydrocele?

Fluid accumulation in the scrotal sac

What is stasis?

Incomplete bladder emptying

What is enuresis?

Incontinence of urine past the age of toilet training

What is Acute Poststreptococcal Glomerulonephritis (APSGN)?

Inflammation and impairment of the glomeruli NOT caused by direct infection of the kidneys

What are the 2 main therapeutic interventions for children with APSGN (think broad)?

Maintain BP Maintain normal volume status

How is VUR managed medically and surgically?

Medically: Continuous antibiotic prophylaxis (mild cases may disappear by age 5) Surgically: Open reimplantation of the ureters or endoscopic correction

What is the most common cause of nephrotic syndrome?

Minimal change disease (MCD)

Which age group is HUS most common in?

Preschool and school-aged children

What is treatment of HUS aimed at preventing?

Renal failure

What is vesicoureteral reflex (VUR)?

Retrograde flow of bladder urine into one or both ureters during voiding

T/F: A child with APSGN can be monitored at home if s/he is NOT hypertensive.

TRUE

T/F: An exposed bladder should be covered with plastic wrap or a sterile plastic bag to keep the organ moist.

TRUE

T/F: Enuresis funs in families

TRUE

T/F: HUS is usually preceded by diarrhea and mainly caused by E. coli

TRUE

T/F: a hx of the viral respiratory tract infection immediately preceding the onset of symptoms of nephrotic syndrome is common

TRUE

T/F: Kids in kidney failure need to be administered IV fluid slowly to prevent heart failure.

TRUE Kidneys can remove excess fluid

T/F: Phenazopyridine can be used for symptomatic management of UTIs

True

T/F: Phenazopyridine causes a reddish-orange staining of urine, tears and contact lenses.

True

Cystitis involves the _______ and the ______

Urethra Bladder

How is VUR diagnosed?

Voiding cystourethrogram (VCUG)