Sherpath: GU Defects, Disorders, & Infections
The pediatric nurse is reviewing the record of a child scheduled for an office visit. Prior to assessing the child, the nurse notes documentation that the child has diurnal enuresis. Based on this diagnosis finding, the nurse plans to include which question during the assessment? "Do you wet the bed at night?" "Do you have a hard time using the bathroom?" "Do you use the bathroom frequently throughout the night?" "Do you wet yourself during the day while you're awake?"
"Do you wet yourself during the day while you're awake?"
A nurse is caring for the parents of an infant who is discovered to have hydronephrosis. The parents ask why the infant will need to be tested for a urinary tract infection (UTI) at birth. Which is the best response by the nurse? "Hydronephrosis is an infection of the kidneys making UTIs likely." "This is a routine testing. We screen all neonates for a UTI at birth." "Hydronephrosis is a malformation of the bladder and urethra, causing urine retention and infection." "Infants with hydronephrosis can have urine flow back into the kidneys from the bladder, causing bacterial growth."
"Infants with hydronephrosis can have urine flow back into the kidneys from the bladder, causing bacterial growth."
A nurse is caring for a 7-year-old male who is not circumcised. The child has had recurrent UTIs. What information should the nurse share with the child to help reduce the likelihood of repeat UTIs? "You may need to take an antibiotic every day to keep from getting UTIs." "Make sure to empty your bladder completely when you go to the bathroom." "Make sure to clean your foreskin carefully each time you go to the bathroom." "Boys are more likely to get UTIs than girls due to the length of their urethra. There is nothing you can do to change that risk factor."
"Make sure to clean your foreskin carefully each time you go to the bathroom."
A 4-year-old has one accident a week at night. She has not gone more than 6 months without an accident. She really wants to fix the problem so she can feel "normal." What type of management should be suggested in this case? Reward systems Behavioral conditioning Pharmacological medications Diet modification to include more carbohydrates
Behavioral conditioning
Immediately after delivery, the nurse notices signs of possible UTI in the neonate. What is the likely bacterial route of the infection? Blood Bladder Vaginal canal Fecal material
Blood Sepsis, bacteria in the blood, is the most likely source as bacteria can seed in the kidney and can cause UTI.
A nurse is working at a urology clinic and arrives at work to an assignment caring for four young children: Child A: A 3-year-old with urethritis Child B: A 15-year-old with cystitis Child C: A newborn with suspected VUR Child D: A 7-year-old with pyelonephritis Which patient should she see first? Child A Child B Child C Child D
Child D A child with pyelonephritis should be seen first. Urinary infections are more serious the further up the urinary tract they are. Pyelonephritis can cause kidney damage if not treated promptly.
An 11-year-old boy acquired a testicular malignancy at the age of 10 years. An abdominal x-ray at the age of 6 months may have revealed which disorder? Phimosis Hydrocele Hypospadias Cryptorchidism
Cryptorchidism
A five-year-old boy presents to the emergency department with severe pain and scrotal swelling and is diagnosed with testicular torsion. The nurse should expect to prepare this patient for which treatment? Ultrasonography Ice and analgesics Emergency surgery High dose antibiotics
Emergency surgery
A 4-year-old female child has had several UTIs during the school year. The nurse knows that which bacteria is most likely causing the young girl's UTIs? Group B Strep K. pneumoniae Proteus species Escherichica coli (E. coli)
Escherichica coli (E. coli)
A 6-month-old infant has dysuria, poor weight gain, and is irritable. The infant is nonfebrile. During the check-up you notice a foul smell from the urine in the diaper. A urinary tract infection (UTI) is suspected and a urine culture (UCS) is ordered. What evidence is used to differentiate UTI from pyelonephritis? Fever Dysuria Irritability Poor weight gain
Fever
Match the disorder with management options:
Hydrocele in newborn Cleaning and manual retraction Phimosis (mild) Observation Testicular torsion Emergency surgery Bladder exstrophy Surgery
A 3-year-old, uncircumcised male is seen in the emergency department for emesis that started 4 hours ago. His mother states he has grade IV vesicoureureteral reflux (VUR). Urinalysis was positive for ketones and urine culture was negative. PO challenge was tolerated with no further emesis. What information would be important to help the family prevent UTI in this patient? (select all that apply) Increase frequency of voiding Proper cleaning of the prepuce Decrease the volume of fluid intake Significantly increase volume intake Antibiotic prophylaxis would be beneficial
Increase frequency of voiding Proper cleaning of the prepuce Antibiotic prophylaxis would be beneficial
The nurse understands that a patient with hydronephrosis will be most predisposed to UTIs because of which change? Increases urine stasis Increases renal perfusion Increases urine production Increases urinary elimination
Increases urine stasis
What questions should help the nurse identify an underlying cause of enuresis? Select all that apply. Is your child losing weight? Does your child currently have a fever? Has your child grown in height recently? Has your child been dry at night until recently? Does your child complain of pain during urination?
Is your child losing weight? Does your child currently have a fever? Has your child been dry at night until recently?
The nurse is caring for a 6-year-old patient with a UTI. The nurse should anticipate which items may be included in treatment? Qinolones Tetracyclines Nitrofurantoin Cephalosporins Trimethoprim-sulfamethoxazole
Nitrofurantoin Cephalosporins Trimethoprim-sulfamethoxazole
A 2-month-old boy was born prematurely and has bilateral cryptorchidism. What information should the nurse give the parents regarding immediate treatment? An orchiectomy will be performed for both testes. Orchiopexy will be necessary to bring the testis down into the scrotal sac. Patient will be observed for spontaneous descent of the testes which is common in the first 6 months of life. Testicular implant can be placed to preserve the scrotal appearance and reduce psychological consequences.
Patient will be observed for spontaneous descent of the testes which is common in the first 6 months of life. Age adjusting for the premature birth, the patient will be managed by observation until 6 months old. Spontaneous descent of the testes is common in the first 6 months of life.
Which other conditions should the nurse assess for in a patient with hypospadias? Patients with hypospadias might also have epispadias. Patients with hypospadias might also have inguinal hernias. Patients with hypospadias might also have testicular torsion. Patients with hypospadias might also have bladder exstrophy.
Patients with hypospadias might also have inguinal hernias.
A child is diagnosed with pyelonephritis. Which should be a priority in caring for the patient? Preventing sepsis Preventing hypertension Preventing hyperthermia Correcting ineffective renal tissue perfusion
Preventing sepsis
A three-year-old patient has recently developed enuresis at preschool. She has not had any urinary accidents for 8 months and does not have any episodes of bedwetting. Identify the classification of enuresis for this patient. Primary, diurnal enuresis Primary, nocturnal enuresis Secondary, diurnal enuresis Secondary, nocturnal enuresis
Secondary, diurnal enuresis
A child presents to the emergency department and is diagnosed with secondary enuresis. Which factors should the nurse consider when suspecting stress-induced secondary enuresis in a young child? Self-esteem Sexual abuse Detrusor instability Nighttime (prebed) habits Recent changes in family dynamics
Self-esteem Sexual abuse Recent changes in family dynamics
The neonatal nurse is expecting a patient born with bladder exstrophy. What feature may have been viewed in the antenatal sonogram? The urinary bladder is located outside of the body. The urinary bladder is located high within the abdominal cavity. The urinary bladder is significantly reduced in size and is barely visible in pelvic cavity. The urinary bladder is significantly enlarged and occupies the majority of the pelvic cavity space.
The urinary bladder is located outside of the body.
What assumption regarding urinary system anatomy can be made if a child is born with hydronephrosis? Urethral atresia Ureter obstruction Low number of nephrons Coalescence of glomeruli
Ureter obstruction
A school-age child is having urinary frequency and urgency. What should be included in the diagnostic evaluation of this child? Select all that apply. Urinalysis Urine culture Evaluation for pinworms Evaluation of psychological state Evaluation for voiding dysfunction Evaluation of blood urea nitrogen (BUN)
Urinalysis Urinalysis should include specific gravity and glucose concentration to check for diabetes. Presence of bacteria for UTI. Urine culture Urine culture can be used to diagnose or rule out UTI. Evaluation for pinworms Infestation of pinworms can cause symptoms similar to UTI. Evaluation of psychological state Social and emotional situations can contribute to enuresis. Evaluation for voiding dysfunction Voiding dysfunction with urge incontinence should be explored.
What conclusion can be drawn when a febrile patient is positive for nitrites and has >500,000 CFU/ml after a clean catch urine culture? Urinary reflux Pyelonephritis Vesicoureteral reflex (VUR) Urinary tract infection (UTI)
Urinary tract infection (UTI)
A 16-year-old female returns to the clinic with symptoms of UTI. This is her second UTI in 6 months since she has become sexually active. What is the most important information the nurse should provide to aid in the prevention of future UTIs? Increase fluid intake Urinate after sexual intercourse Increase the frequency of urination Urinate when first urge to void is sensed
Urinate after sexual intercourse The UTIs developed after patient became sexually active. This indicates she may need education related to urination after intercourse to flush the urethra.
What is the next step in diagnosis of urinary tract infection (UTI) when urine dipstick shows nitrites and urinalysis shows hematuria and white blood cells? Urine culture Analysis of ketones Analysis of glucose in urine Estimation of glomerular filtration rate (GFR)
Urine culture Any bacterial growth of a single-strain bacterium >100,000 CFU/mL in a clean-catch urine specimen establishes a diagnosis of UTI.
What is a likely consequence of urine reflux? Urine reflux leads to pyrexia. Urine reflux can lead to hypertension. Urine reflux increases urine stagnation. Urine reflux leads to increased urine acidity.
Urine reflux increases urine stagnation.
