Chapter 29 the child with a GU condition

A priority nursing responsibility in the care of a child with Wilms' tumor is to: 1. maintain accurate intake and output records. 2. omit abdominal palpation during daily assessments. 3. maintain strict bed rest. 4. assess neurological function.

2. omit abdominal palpation during daily assessments.

What is the name of the condition in which the urinary meatus is located on the underside of the penis? a) Hypospadias b) Epispadias c) Phimosis d) Chordee

a) Hypospadias

What is included in preventive teaching for urinary tract infections (UTIs) in girls? (Select all that apply.) a) Wearing nylon underwear b) Encouraging fluids c) Wiping front to back d) Avoiding bubble baths e) Encouraging use of talcum powder

b) Encouraging fluids c) Wiping front to back d) Avoiding bubble baths

enuresis

bed wetting

What is the approximate bladder capacity of a 4-year-old child? a) 2 ounces b) 4 ounces c) 6 ounces d) 8 ounces

c) 6 ounces

hydrocele

fluid in sac surrounding testicle, resolves itself by 1yr

wilms tumor

happens in utero, most common malignancy in early life, no sx in early stages in growth of tumor, found during check up by palpating mass in abdomen, *when suspected avoid abdominal palpation*

acute glomerulonephritis

immunologic reaction to group A strep, *can cause oliguria, if they have oliguria avoid foods with potassium, avoid child from getting over tired, decrease activity, keep child as still as possible, can cause gross hematuria, promote bedrest, prevent visitors, avoid child from going to playroom, encourage limited activity, let them color or play computer games, make sure safety measures are in place, notify doc if child BP increases*

nephrotic syndrome sx

proteinuria, generalized edema, hypoalbuminemia, fatigue

exstrophy of bladder

bladder lies open and exposed on abdomen, urine leaking continuously causing skin breakdown (to prevent cover bladder with nonadhering dressing), high risk for infection, prevent infection, first sign of infection is fever, get urinalysis and check labs to determine renal impairment, place diapers underneath baby to protect bladder, position baby on back or side so urine drains freely

Which diagnosis often accompanies cryptorchidism? a) Wilms' tumor b) Pyloric stenosis c) Paraphimosis d) Inguinal hernia

d) Inguinal hernia

A 2½-year-old child is being discharged after a hypospadias repair. Which of the following cautions should the nurse include in the post-op instructions for parents? Select all that apply. a. Leave the diaper off until the site is healed. b. Restrict fluids to reduce output for 1 week. c. Continue with toilet training. d. Avoid straddling the infant on the hip. e. Avoid tricycle riding as a play activity.

d. Avoid straddling the infant on the hip. e. Avoid tricycle riding as a play activity.

nephrotic syndrome

more common in boys, at risk for infection, have parent keep record of daily weight, urinary protein levels and meds, dont restrict fluids unless massive edema present, *no added salt diet, measure abdominal girth daily*

UTI in child

most commonly caused by e-coli, avoid bubble baths, wipe front to back, wear cotton underwear and loose fitting pants, adequate fluid intake, void frequently to prevent bacteria buildup

postop surgery for hypospadias and epispadias

no tub bath

indication of nephrotic syndrome in child/first sign*

periorbital edema

nephrotic syndrome if child is on steroids

postpone immunizations

no circumcision for hypospadias and epispadias because

they might need foreskin for repair during surgery

cryptorchidism

undescended testes, can result in infertility and inguinal hernia or strangulated hernia, -tx: orchiopexy (fixation of testes) most common complication infection and bleeding, tell parents how to do wound care and keep things clean and hand hygiene

epispadias

urinary meatus is on upper surface of penis

most accurate way to determine edema

weight of child

hypospadias

urinary meatus is on lower portion of shaft

The nurse is caring for a child diagnosed with nephrosis. Symptoms that are characteristic of nephrosis include which of the following? Select all that apply. 1. Massive proteinuria 2. Edema 3. A positive antistreptolysin titer 4. Bacteriuria

1. Massive proteinuria 2. Edema

The nurse understands that genitourinary surgery affects growth and development. When caring for a 4-year-old child postoperatively, a priority nursing responsibility would include: 1. strategies to preserve the child's body image. 2. assurances that appearance and sexual function will not be affected. 3. providing age-appropriate toys such as tricycles. 4. preventing embarrassment by limiting visitation of family and friends.

1. strategies to preserve the child's body image.

The administration of prednisone to children with nephrosis creates the problem of: 1. intolerance to foods. 2. increased risk of infection. 3. increased periorbital edema. 4. weight loss.

2. increased risk of infection.

Daily weights are obtained in children with nephrosis to monitor: 1. weight loss from a low-protein diet. 2. accuracy of fluid balance sheets. 3. changes in the amount of edema. 4. percentile on the growth grid.

3. changes in the amount of edema.

Which organism is the most common cause of urinary tract infections in children? a) Escherichia coli b) Staphylococcus c) Klebsiella d) Pseudomonas

a) Escherichia coli

Which term is a narrowing of the preputial opening of the foreskin, which prevents the foreskin from being retracted over the penis. a) Phimosis b) Hypospadias c) Epispadias d) Chordee

a) Phimosis

A 16-year-old boy enters the emergency department reporting acute scrotal pain. He is diagnosed with testicular torsion. What treatment for this condition will the nurse expect? a) Application of cool compresses b) Immediate surgery c) Ultrasound-guided external manipulation d) Rest and elevation

b) Immediate surgery