3 alterations of renal and urinary function in children

bergers disease

Immunoglobulin A (IgA) Nephropathy an autoimmune thing same thing as last card but theres no strep antibody complexes get stuck

epispadias

above, urethral opening is on the top of the penis they put the get

exstrophy of the bladder

bladder is outside the body

horseshoe kidney

congenital malformation in which both kidneys are joined together by an isthmus, most commonly at the lower poles

bladder outlet obstruction

structural abnormality that blocks the urethra. Causes urine to back up into the ureters and then kidneys eventually leading to hydroureters and hydronephrosis

theories on enuresis

- Organic causes (DM?) (can be because your kid is diabetic) - Factors that increase urine production - Maturational lag - Genetic factors - Sleep patterns - Psychosocial theories

A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening the client's urinary output is much less than the intake. When it is confirmed that the bladder is not distended, what should the nurse suspect developed? 1.Oliguria 2.Hydroureter 3.Renal shutdown 4.Urethral obstruction

2

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation? 1.Urine is clear amber 2.Urination is not painful 3.Urge incontinence is not present 4.A reddish-orange discoloration of the urine is present

2

The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure? 1.Increase in blood pressure 2.Decrease in erythropoietin 3.Increase in serum phosphate levels 4.Decrease in serum sodium concentration

2

A client presents to the emergency department with shortness of breath, bloody sputum, weight gain, generalized edema, and a blood pressure of 150/110. The nurse reviews the client's laboratory results and determines that the client has impaired renal function. Which diagnosis will the nurse most likely observe written in the client's electronic medical record? 1.Kidney stone 2.Nephrotic syndrome 3.Hemolytic uremic syndrome 4.Glomerulonephritis

2 they have a high BP, generalized edema, etc

A client with a femoral fracture associated with osteomyelitis is immobilized for 3 weeks. The nurse assesses for the development of renal calculi. What is the rationale for the nurse's assessment? 1.The client's dietary patterns have changed since admission. 2.The client has more difficulty urinating in a supine position. 3.Lack of weight-bearing activity promotes bone demineralization. 4.Fracture healing requires more calcium, which increases total calcium metabolism.

3

The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination? 1.Fever, diarrhea, groin pain, and ecchymosis 2.Nausea, painful scrotal edema, and ecchymosis 3.Fever, nausea, vomiting, and painful scrotal edema 4.Diarrhea, groin pain, testicular torsion, and scrotal edema

3

hypospadias

opening of the urethra is on the bottom/back side of the penis chordee (term for the penis bending downward due to the placement of the urethra in hypospodias)

UTIs

same as in adults most commonly caused by ecoli encourage your kids to go to the bathroom--holding it can cuase UTI

ureteropelvic junction obstruction (UJP)

structural abnormality where the ureter joins with the renal pelvis we have to go in surgically adn fix whatever is causing it to be obstructed when the kidney fills up and is drowning, hydronephrosis happens

potter syndrome

you were born with no kidneys at all they normally don't survive at all

Acute Post-Streptococcal Glomerulonephritis

- strep infection - peeing blood - injures the glomerulus uOccurs after a throat or skin infection with certain strains of group A alpha-hemolytic streptococci uExperience a sudden onset of hematuria, edema, hypertension, and renal insufficiency uAntigen-antibody complexes and complement are deposited in the glomerulus uThe immune complexes initiate inflammation and glomerular injury

HUS manifestations

- weak - pale - bruises - bloody diarrhea - fever (sign of systemic infection) - mild jaundice (from destruction of RBC's bc bilirubin is in RBCs) - early renal failure put them on dialysis to support their kidneys as well as giving them lots of fluids

The nurse is reviewing a client's record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding? 1.Elevated creatinine level 2.Decreased hemoglobin level 3.Decreased red blood cell count 4.Increased white blood cells in the urine

1

The nurse is explaining the physiologic reasons for taking vitamin D and calcium supplements to a client with renal failure. Which statement made by the nurse is appropriate? 1."There will be a decrease in the inactive forms of vitamin D in your body." 2."There will be a decrease in the active metabolite of vitamin D in your body." 3."There will be an increase in the conversion of skin cholesterol into vitamin D." 4."There will be an increase in the vitamin D associated intestinal absorption of calcium."

2

nephroblastoma/ wilms tumor

an embryonic tumor (their renal stem cells start growing and they don't stop) usually diagnosed by parents d/t abdominal swelling

Bryan is a 6-year-old with hemolytic uremic syndrome. He will be your patient today. What signs and symptoms do you expect to see when you go to care for him? What assessments do you need to make, and what are some of your priorities for his care?

brusied, renal failure, vommiting, pale, etc.

incontinence/enuresis

by the time a child is 4 or 5 years old, they should not be wetting their pants/bed kids sleep so deeply sometimes that the urge to pee doesn't wake them up, that can be normal up until age 10 or 11 - Involuntary passage of urine by a child who is beyond the age (4 to 5 years old) when voluntary bladder control should have been acquired - Primary enuresis - The child has never been continent - Secondary enuresis (they used to be fine but now they're not--usually trauma, something happened) - Daytime enuresis - Nighttime enuresis

Hemolytic Uremic Syndrome (HUS)

for sure have to know this!! most common cause of renal failure in kids three pieces: - its hemolytic (RBCs are being destroyed from ecoli). ecoli is the cause--the toxicness of ecoli causes the RBCs to rupture and die - they start to form little tiny clots everywhere--platelets are in clots, so if you form too many of these clots, you will have a low amount of platelets left circulating in the bloodstream. Also, the clots get stuck in the glomeruli causing them to get inflamed. The RBCs that are damaged get filtered out by the spleen.

Olivia is 10 years old and missed school one week ago for a severe sore throat and fever. Today, she is sick again and her mother brings her to the clinic with a recurrent fever, headache, irritability, and new onset hematuria. During the initial examination, you discover that she has flank pain. What disorder do you suspect that she may have? What other kinds of assessments will be done?

glomerulonephritis acute post streptococcal glomerulonephritis

nephrotic syndrome

in kids same thing where we have a massive protein loss so a ton of edema damage to the microvasculature in the kidneys same as for aduly idiopathic= we don't know what cause it

Adam is a 3-year-old admitted with primary nephrotic syndrome. What signs and symptoms would you expect to see, and what is the underlying cause of those?

periorbital edema, proteinuria, tachycardia, vomitting, etc. the cause of nephrotic syndrome is the destruction of the small blood vessels in the glomerulus

polycistic kidney disease

the kidney tunrs into the size of a football, VERY painful they normally have HTN with them, its genetic as well

renal agenesis

they only have one kidney unilateral agenesis means it never formed

hydroplastic or dysplastic kidneys

theyre small and deformed small kidneys are usually fine

Cody is a 4-year-old whose mother detects a firm, smooth mass in his abdomen while bathing him. He has no pain when she touches the mass. She brings him to the ER to find out what this is and how it needs to be managed. What will she likely be told about the diagnosis?

this is nephroblastoma/Wilms tumor highly curable/ cured by surgery

vesicoureteral reflux (VUR)

urine is flowing backwards the ureter is not at the right spot it gets worse and worse --view image for example diagnosed by putting fluid into the bladder through a catheter with dye so they can see