GU

School-age child with urosepsis. Which assessment finding should the nurse expect?

Fever with a positive blood culture

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show:

Hematuria & proteinuria.

Defects

Hydrocele: fluid in scrotum Hydrospadias: urethral opening located behind glans of penis epispadias: meatal openining located on dorsal surface of penis chordee: ventral curvature of penis cryptochridism: failure for testes to descend

Adolescent being discharged to home after a renal transplantation. The adolescent needs further teaching if which statement is made?

I am glad I only have to take the immunosuppressant medication for two weeks.

Teaching plan for the parents of a child with vesicoureteral reflux?

Importance of taking prophylactic antibiotics Prophylactic antibiotics are used to prevent urinary tract infections (UTIs) in a child with vesicoureteral reflux,

Common side effect of corticosteroid therapy is:

Increased appetite.

PID

Infection of lower (vagina/cervix) and upper (fallopian tubes) in females S/S: lower abd pain vaginal discharge irregular bleeding dysuria N/V, fever peritoneal signs - decreased fertility -tubal ovarian abscess - chronic pelvic pain - ectopic pregnancy 70% <25 years N.gonorrheae Chlamydia trachomatis Mycoplasmas E. Coli

The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to detect an early sign of:

Infection.

An advantage of peritoneal dialysis is that:

Parents and older children can perform treatments.

Narrowing of preputial opening of foreskin is called:

Phimosis

Diagnostic finding is present when a child has primary nephrotic syndrome?

Proteinuria Large amounts of protein are lost through the urine as a result of an increased permeability of the glomerular basement membrane.

Child with chronic renal failure about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections.

RBC should begin to improve with these injections.

An objective of care for the child with nephrosis is to:

Reduce excretion of urinary protein

Diagnostic test allows visualization of the renal parenchyma & renal pelvis without exposure to external beam radiation or radioactive isotopes?

Renal ultrasound

Child with secondary enuresis who complains of dysuria or urgency should be evaluated for what?

UTI Diabetes mellitus

Clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant uremic breath odor

Chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as:

Uremia.

pediatric considerations

Urinary - kidneys are immature & short - small tubules - age + 2oz capacity, 20mL at birth Reproductive fetal differentiation at 8wks b/c of hormones remains immature until puberty

First indication of acute glomerulonephritis is improving. The nurses best response should be that the:

Urinary output will increase.

Infant w/ urinary tract infection clinical manifestations

Vomiting Failure to gain weight Persistent diaper rash

Kidneys

filters the blood & help remove waste & extra fluid from the body. they help control bodys chemical balance: -BP -circulation -weight

Acute post-strep glomerulonephritis

immune complex condition NOT infectious disease caused by group A beta hemolytic strep occurs in 90% renal disorders sudden appearance of edema, hematuria, proteinuria & hypertension

Bed wetting

medication Desmopressin (DDAVP) to make less urine at night. 50% effective.

UTIs

most common pediatric infection peak 2-6y Females > males because of shorter urethra, shorter distance for bacteria to travel gram negative proteus: E.Coli pseudomonas klebsiella enterobacter staph, strep 50k colony forming units per mL nitrates

Toilet Training

physical control: 18-24m psychologically ready: 18-36mo limit timing 5-8min max 40-60% by 36m

nephrotic syndrome

so much protein in urine! hypoalbuminemia hyperlipidemia edema most common* 2-7years medication: steroids antibiotics

Therapeutic management of nephrosis includes:

Corticosteroids.

School-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?

Creatinine clearance

Chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to administer?

Sodium polystyrene sulfonate (Kayexalate)

The urogenital system arises during the:

4th week of development urine formation begins towards the end of wk 11 & 12

Hemolytic Uremic Syndrome

6m - 5 yrs can cause AKI Features: anemia thrombocytopenia renal injury CNS symptoms

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is:

Excess Fluid Volume related to decreased plasma filtration.

Exacerbation of nephrotic syndrome clinical manifestations

Facial edema Fatigue Frothy-appearing urine

Dialysis. The Adolescent seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to:

Adolescents often resenting the control & enforced dependence imposed by dialysis.

Acute glomerulonephritis and oliguria. Which dietary menu items should be allowed for this child?

Apples Carrot sticks Strawberries

Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to:

Bind phosphorus.

What clinical manifestation is a sign of hyperkalemia?

Cardiac arrhythmia

Hypospadias refers to:

Congenital condition in which the urethral opening is located anywhere along the ventral surface of the penis. The urethral opening is present, but not at the glans.

Clinical manifestations of chronic renal failure is uremic frost. What best describes this term?

Deposits of urea crystals on skin

Descriptive statement of renal transplantation in children?

It is preferred means of renal replacement therapy in children.

Diet of a child with chronic renal failure is usually characterized as:

Low in phosphorus.

Primary clinical manifestations of acute renal failure are:

Oliguria and hypertension.

PSGN

S/S: periorbital edema anorexia tea colored urine dysuria headaches abd pain flank pain mild to mod renal insufficiency acute edema 4-10 days to 2-3 weeks high BUN & Cr treatment water & sodium retrictions diuretics corticosteroids antibiotics for throat infection

Diet of a child with nephrosis usually includes:

Salt restriction.

Most common cause of acute renal failure in children is:

Severe dehydration.

Which factor predisposes a child to urinary tract infections?

Short urethra in young girls

A preschool child is being admitted to the hospital with dehydration & a UTI.

WBC >2; specific gravity 1.030

Which intervention is appropriate when examining a male infant for cryptorchidism?

Warming the room

A major complication in a child with chronic renal failure is:

Water & sodium retension.

What should the nurse recommend to prevent urinary tract infections in young girls?

Wearing cotton underpants

Diet of a child experiencing severe edema associated w/ acute glomerulonephritis. Which information should the nurse include in the teaching?

You will need to avoid salt to your child's food.