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80 Cards in this Set
- Front
- Back
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What is gender is more likely to get UTI's?
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girls
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What is the prime age for UTI's?
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2-6
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What is stasis?
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urine sitting in bladder too long
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When should you void?
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at least every 4 hrs
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What are some s/s of a UTI in neonates?
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tachypnea
jaundice screaming on urination |
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What are some s/s of UTI in infants?
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frequent urination
straining or screaming on urination foul smelling urine fever persistent diaper rash enlarged kidney or bladder |
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What are some s/s of UTI in childhood?
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enuresis
facial swelling fatigue hematuria abdominal or back pain edema hypertension tetany |
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What is a culture & sensitivity?
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tells what bacteria it is and what antibiotics to use
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What diagnoses a UTI?
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more than 100,000 colonies/mL of clean urine
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What diagnostic tests may be used if there are repeated UTIs?
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VCUG or IVP
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What is a VCUG?
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instill bladder with radioactive isotope and have the child void while taking xray to assess bladder and lower urinary tract
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What is an IVP?
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radioactive isotope put into vein and collected in the kidneys to look at the venous structure of the kidneys
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What is the management of a UTI?
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stop infection
detect/correct anatomic anomalies prevent recurrence avoid kidney damage |
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What is the treatment for a UTI?
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sulfominades and tetracyclines if > 8
increase fluid intake tylenol to reduce pain and fever |
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Why would pyridium be given for a UTI?
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pain, turns everything orange
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What are some things to do to prevent UTIs?
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hydration
void every 4 hours no bubble baths clean front to back void after intercourse regular baths cotton underwear |
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What is vesicoureteral reflux?
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urine flows backward from the bladder into the ureters
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What are the causes of vesicoureteral reflux?
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defective valve
ureters improperly placed bladder is too small |
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What is the patho of vesicoureteral reflux?
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baldder contracts, some urine flows up ureters, bladder relaxes, urine in ureters flows back into bladder, constant urine in bladder causes stasis
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How is vesicoureteral reflux graded?
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1. reflux limited to ureters
2. reflux reaches renal pelvis; no dilation 3. ureters dilated 4. ureters and renal pelvis dilated 5. progressive dilation |
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How can you diagnose vesicoureteral reflux?
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VCUG
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How can you manage vesicoureteral reflux?
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treat UTI vigorously
teach double voiding prophylactic antibiotics cystoscopy ureteral reimplantation |
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What is double voiding?
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remain on the toilet until your bladder feels empty. Then stand up for 10 to 20 seconds, sit down, lean slightly forward over your knees, relax, and wait until your bladder empties completely
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What should you educate your pt about after a ureteral reimplantation?
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will be painful afterwards, urine will be bloody
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What should be done post op of a ureteral reimplantation?
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pain management
bladder spasm control *ditropan strict I/O monitor urine |
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What is minimal change neprhotic syndrome?
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most common kind of neprhosis in children
permeability of the glomerular membrane changes so much that protein is lost |
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What are the four main characteristics of minimal change neprhotic syndrome?
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proteinuria
edema low serum albumin hyperlipidemia |
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What should you assess for with minimal change neprhotic syndrome?
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periobitial edema (puffy eyes)
general malaise ascites anorexia irritability N/V increased risk for clotting d/t decreased blood vol |
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How can you diagnose minimal change nephrotic syndrome?
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proteinuria: up to 15 grams/ 24 hr collection
hyperlipidemia scant hematuria clinical presentation kidney biopsy |
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What is the management for minimal change nephrotic syndrome?
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steroids: prednisone
24 hour urine collection about once a wk should see diuresis 10 days to 6 wks encouraged to walk to help voiding taper prednisone |
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What are some complications of minimal change nephrotic syndrome?
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skin impairment d/t swelling
circulatory insufficiency d/t clots infection r/t prednisone recurrence is not unusual |
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What is the nursing care for minimal change nephrotic syndrome?
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strict I/O to watch for diuresis
encourage protein intake skin care HOB elevated possible salt/fluid restriction immunosuppressant education avoid IM |
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What is acute glomerulopnphritis?
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glomeruli become inflamed, clogged, inefficient at filtration causing protein and blood to leak into urine, sodium and fluid to accumulate in blood and circulatory congestion results
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What are the causes of glomerulonephritis?
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infections (strep)
immune dx glomeruli vasculitis conditions that scar *UTI, vasculitis |
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What would a pt's urine look like if they had glomerulonephritis?
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dark tea colored
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What are some s/s of glomerulonephritis?
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sudden onset of gross hematuria
protein 1 gram/24 hour collection UA: WBCs, casts, increased specific gravity hypertension from increased blood volume abdominal pain, anorexia, nausea low-grade fever |
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How can you diagnose glomerulonephritis?
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hematuria
increased BUN, creatinine mild anemia *dilution possible evidence of recent strep decreased blood protein clinical presentation |
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How can you manage glomerulonephritis?
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manage systems
digoxin d/t increased blood vol oxygen vasodilators control diet daily weight possible anticonvulsants |
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What is the nursing care for glomerulonephritis?
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education on treating strep, UTIs, dx process
medication teaching preventing, treating strep infection emporary dialysis |
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What are some complications of glomerulonephritis?
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acute kidney failure
chronic kidney failure high blood pressure nephrotic syndrome |
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What are the causes of chronic renal dx?
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nephrotoxic medications
renal scarring- recurrent UTI hereditary d/o systemic diseases: lupus structural anomalies |
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What is chronic renal insufficiency?
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renal function less than 50%
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What is chronic renal failure?
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renal function less than 25%
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What is end-stage renal dx?
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renal function less than 5%
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What is the patho of chronic renal dx?
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no s/s until 50-80% of function is lost
inability to concentrate urine inability to produce urine unable to excrete H+ ions leading to acidosis bone salts used to buffer acid leading to osteodystrophy vitamin D production decreased erythropoeitan production decreased leading to anemia hypocalcemia, hyperphosphatemia leading to heart problems growth slows or stops |
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What are some s/s of chronic renal failure?
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poor appetite/ vomiting
bone pain HA stunted growth malaise high urine output or no urine output recurrent urinary tract infections urinary incontinence pale skin bad breath hearing deficit detectable abdominal mass tissue swelling irritability poor muscle tone change in mental alertness |
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How can you diagnose chronic renal ds?
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blood tests
urine tests chest xray bone scan renal ultrasound electrocardiogram renal biopsy |
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What is the normal GFR?
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120-125 mL/min
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What is the normal creatinine?
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<0.8 mg/dL
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What is the normal BUN?
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5-25 mg/dL
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What are some treatment concerns for chronic renal ds?
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blood pressure monitored with meds
monitor phosphorous, potassium, protein, salt, fluid anemia may be treated with epogen injections growth is often stunted |
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What is periotoneal dialysis?
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sterile cath placed into peritaneal cavity
get baseline wt & vitals void if possible, clean with betadine |
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What is a hemodialysis?
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filtration thru the blood
blood comes from artery and back into vein |
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What are some nursing diagnosis for a pt on dialysis?
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risk for infection
risk for dehydration risk for fluid overload |
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What are some nursing diagnosis for a pt with chronic renal ds?
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depression/body image concerns
financial/ emotional stress for family social isolation limited diet |
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What is hypospadias?
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urethral opening on ventral side of penis (bottom)
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What is epispadias?
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urethral opening on dorsal surface of penis (top)
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What doesn't need to happen to a baby with hypospadias or epispadias?
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circumcision
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What can cause hypospadias?
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cryptorchidism (undescended testes)
chordee (head of penis curves downward |
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What can cause epispadias?
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bladder extrophy and spina bifida
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How can you manage hypospadias and epispadias?
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meatotomy- extend urethra to normal position but using foreskin as extension b/t 12-18 months
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What is bladder exstrophy?
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midline closure defect- first 8 wks of gestation
can show on ultrasound bladder open, split urine drains constantly pelvic bones may be malformed |
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How can you manage bladder exstrophy?
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surgical closure of bladder
closure of anterior abdominal wall may require serial surgeries bryant's traction to allow site to heal and pelvic bones to form |
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What is bryant's traction?
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Both the patient's limbs are suspended in the air vertically at a ninety degree angle from the hips and knees slightly flexed. Over a period of days, the legs hips are gradually moved outward from the body using a pulley system. The patient's body provides the countertraction.
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What is the preop nursing care for bladder exstrophy?
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keep exposed bladder sterile
protect skin where urine draining |
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What is the postop nursing care for bladder exstrophy?
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manage traction
incision care IV hydration/antibiotics care for mother support/education |
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What is the patho of alport's syndrome?
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x-linked
type IV collagen in glomerular basement membrane is absent or abnormal bilateral kidney failure deafness may result in eye defects |
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What are some s/s of alport's syndrome?
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hematuria present from birth
fatigue anorexia anemia proteinuria deafness developed at young age |
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How can you diagnose alport's syndrome?
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kidney biopsy
urine test for blood and protein family history |
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How can you treat alport's syndrome?
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similar to chronic renal ds
possible bone marrow transplant |
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What is prune belly syndrome?
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eagle-barrett syndrome
anterior abdominal wall: musculature is deficient or absent urinary tract anomalies (mega-ureters, large bladder) bilateral cyrptorchidism (undescended testicles) |
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When does prune belly syndrome occur?
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in utero
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How do you diagnose prune belly syndrome?
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obvious at birth but varying degrees of severity
radiologic studies confirm assess for cyptorchidism respiratory difficulties rare, cardiovascular anomalies |
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What is the treatment for prune belly syndrome?
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aggressive surgical repair
or no surgical intervention |
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What is the nursing care for prune belly syndrome?
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education/support
care with dialysis postop care |
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What is hemolytic uremic syndrome?
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occurs most often after gastroenteritis caused by E. coli
bacteria lodged in the digestive system make toxins that enter the bloodstream and start to destroy RBCs misshapen cells clog tiny blood vessels in the kidneys |
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What are some s/s of HUS?
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hemolytic anemia
thrombocytopenia acute renal failure bloody stools no fever decreased or absent UOP petechia hx of gastroenteritis presence of schistocytes- fragmented, deformed, irregular, or helmet shaped RBCs thrombocytopenia- < 60,000 |
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What is a normal platelet count?
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150,000-400,000
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How can you treat hemolytic uremic syndrome?
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careful rehydration
bowel rest NPO transfusions dialysis in severe cases, plasma exchange |
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What is the nursing care for hemolytic uremic syndrome?
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recognize s/s
dialysis education on dialysis avoid undercooked beef swimming in unclean pools hand hygiene |
