Term
| What is the functional unit of the kidney? |
|
Definition
|
|
Term
| How does the aorta flow into the kidney? |
|
Definition
|
|
Term
| How much cardiac output does the kidney's receive? |
|
Definition
|
|
Term
| Why do the kidneys need adequate blood pressure & volume? |
|
Definition
| 20% of the blood plasma is filtered each minute |
|
|
Term
| How does the blood leave the kidneys? |
|
Definition
| Through the inferior vena cava |
|
|
Term
| How many nephrons are in the cortex of the kidney? |
|
Definition
|
|
Term
| What is the filtered plasma called in the nephron? |
|
Definition
|
|
Term
| What is the left over filtrate called? |
|
Definition
|
|
Term
| What are substances reabsorbed by the kidney and put back into the blood to maintain homeostasis? |
|
Definition
| Electrolytes, glucose, fatty acids, amino acids, water |
|
|
Term
| Water are the functions of the kidneys? |
|
Definition
Water Balance
Get rid of waste products
Conserve bicarbonate (pH control)
Produce mineral corticoids
Produce Renin
Produce Erythropoietin
Produce Aldosterstone |
|
|
Term
| What hormone regulates water balance? |
|
Definition
| ADH secreted by p. pituitary |
|
|
Term
| What are the waste products excreted by the kidney? |
|
Definition
| Urea, creatinine, metabolic acids, chemicals, drugs, excess ions |
|
|
Term
| What hormone tells the kidney to reabsorb calcium from filtrate? |
|
Definition
|
|
Term
| How is aldosterone regulated and where is it secreted? |
|
Definition
| Regulated by Na+ & K+, secreted by the adrenal cortex. Action to increase Na+ reabsorption to retain water & secrete K+ from the body |
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|
Term
| What is the urine production rate in infants, children, & adolescents? |
|
Definition
Infant: greater than or equal to 2 ml/kg/hr
Child: greater than or equal to 1 ml/kg/hr
Adolescent: greater than or equal to 1 ml/ minute |
|
|
Term
| When does the most growth occur for the kidney's? |
|
Definition
Most 0-5 years
Full by 10 y/o |
|
|
Term
|
Definition
Abnormally high amounts of nitrogen waste
Seen in creatinine levels & BUN |
|
|
Term
| How big is the bladder for a child at birth compared to an adult? |
|
Definition
Birth 20-50 ml
Adult 700 ml |
|
|
Term
| When can children be toilet trained? |
|
Definition
| At age 2 because there sphincter gains control by this age |
|
|
Term
|
Definition
| obstruction or backflow causing a swollen kidney |
|
|
Term
| What is the normal GFR for an adult? |
|
Definition
|
|
Term
|
Definition
| Involuntary voiding for a child old enough for voluntary bladder control ( by 3.5 Yrs expected) |
|
|
Term
| What are the types of enuresis? |
|
Definition
Nocturnal: Night
-Primary: never dry at night
-2º Dry for six months before wetting at night
Diurnal: Day |
|
|
Term
| What are causes for enuresis? |
|
Definition
| Small bladder, family hx, delayed neuro growth on voluntary muscle fibers, associated with sleep apnea |
|
|
Term
|
Definition
| It causes vasoconstriction to increase BP |
|
|
Term
| What causes higher urine concentration and prevents people from urinating at night? |
|
Definition
|
|
Term
| What diseases should you rule out first when assessing enuresis? |
|
Definition
UTI (especially 2º nocturnal), diabetes, spina bifida
Stress can also cause enuresis |
|
|
Term
| What should be done to treat enuresis? |
|
Definition
Measure bladder capacity & residual test
Fluid restriction before bed
Alarms
Medications |
|
|
Term
| What medications can be given for Enuresis? |
|
Definition
Imipramine: antidepressant
Desmopressin: decrease the amount of urine produced
Oxybutynin: antispasmodic |
|
|
Term
| What is Nephrotic syndrome? |
|
Definition
| An alteration in kidney function 2º to an increase of the glomerular basement membrane permeability to plasma protein |
|
|
Term
| What causes primary Nephrotic syndrome? |
|
Definition
| Disease that affects only kidney (glomerular nephritis usually after strept throat) |
|
|
Term
| What causes 2º Nephrotic syndrome? |
|
Definition
| Systemic disease, drug, or toxin |
|
|
Term
| What is another name for congenital nephritis? |
|
Definition
|
|
Term
| What happens with nephrotic syndrome? |
|
Definition
| Too many proteins (albumin) are go into the GF resulting in decreased oncotic pressure. This leads hypoalbemia and hypovolemia and Na+ is retained thru the renin-aldosterone cascade. ADH is also released. More clotting factor and albumin is also released. Swelling occurs and more protein goes with it continuing the cycle. |
|
|
Term
| What is the treatment for nephrotic syndrome? |
|
Definition
Corticosteroids (prednisone): decreases proteinuria
- 2-3 weeks b4 results then EOD for 6 weeks 50% will relapse
IV albumin to retain water
diuretics to reduce enema
Ace inhibitors |
|
|
Term
| What type of diet is given for nephrotic syndrome? |
|
Definition
Normal, No salt added during steroid treatment, normal fluids unless edema is severe
Remember: steroids make kids hungry |
|
|
Term
| What is polycystic kidney disease? |
|
Definition
| Polycystic kidney disease (PKD) is an inherited disorder in which clusters of cysts develop primarily within your kidneys. Cysts are noncancerous round sacs containing water-like fluid. The cysts vary in size and, as they accumulate more fluid, they can grow very large. Complication: High BP |
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|
Term
| What happens to a child born with polycystic kidney disease? |
|
Definition
| They need a kidney transplant. |
|
|
Term
| What is HUS (hemolytic-Uremic Syndrome)? |
|
Definition
| Is an acute disease, Caused by a toxin, the most common cause of acute renal failure in children and can also cause chronic renal failure. 40% end up on dialysis. 2 yrs or less. |
|
|
Term
| What are the symptoms of HUS? |
|
Definition
Hemolytic anemia
Thombocytopenia
Acute renal failure |
|
|
Term
|
Definition
| E. coli attaches to glomerulus, the ducts, and tubules causing them to swell and occlude in the glomerular arterioles. RBC hemolyze causing anemia. Platelets congregate decreasing the platelet count causing Thrombocytopenia. The RBC & PLT clog the kidneys and cause Acute renal failure. |
|
|
Term
| What is the treatment for HUS? |
|
Definition
Antihypertensives
Fluid restriction
Diet (low Protein, K+, Na+, Phosphorus)High calorie, high carbs
Dialysis to save kidneys (Nephrons grow back in young)
Kidney transplant
Antidiarrheal contraindicated (Retains toxin, or microbe) |
|
|
Term
|
Definition
Cook meat at 155 Fº
Wash hands and utensils carefully when handling raw meat
Use separate cutting board for meat & veggies |
|
|
Term
| What is Acute Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
| An inflammation of the glomerulus, 3-14 days post strept throat, mostly less than 2 years old |
|
|
Term
| What is a common cause of Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
| Group A Beta-Streptococcus |
|
|
Term
| What are drugs used for Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
HTN:
nifedipine
amlodipine
Lasix
No antibiotics unless strept + |
|
|
Term
| What are diagnostic indicators of Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
Sedimentation rate increased
Aso increased
anti strept test
Ultrasound (looking for cancer)
Increase in serum lipids, WBC can also be high |
|
|
Term
| What are symptoms of Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
Periorbital edema
decreased urine output
HTN
hematuria
edema |
|
|
Term
| What happens in a patient with Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
| An immune inflammatory response occurs due to the endothelial cells swelling. Capillaries occlude and spasms occur. There is increased membrane permeability causing the too much protein loss and the Renin cascade. |
|
|
Term
| What is the Tx for Postinfectious Glomerulonephritis (APIGN)? |
|
Definition
| Bedrest, antiHTN drugs, diuretics, steroids, penicillin to make sure |
|
|
Term
| What are the symptoms of Capillaries occlude and spasm? |
|
Definition
| Tea colored urine due to blood, periorbital edema, decreased urine output |
|
|
Term
| What are diet restrictions? |
|
Definition
| Fluid & salt restrictions (1-2 mEq/kg/day) |
|
|
Term
| What is bladder exstrophy? |
|
Definition
| The bladder is outside the body when child is born, more common in males |
|
|
Term
| How is Hypospadias & bladder exstrophy tx? |
|
Definition
| Saline sterile dressing placed on abdomen, surgery within 24-48 hrs to close the abdominal wall, diversion bladder created (superpubic cath), many surgeries to follow |
|
|
Term
| What are considerations for a nurse Hypospadias & bladder exstrophy? |
|
Definition
Circumcision contraindicated (tissue needed)
Wound & skin care
Infection management
Pain management
Measure urine output |
|
|
Term
| What are stents used for in Hypospadias & bladder exstrophy? |
|
Definition
| Used to maintain urethral patency to prevent occlusion from scar tissue |
|
|
Term
|
Definition
| A short urethra on a penis, urethra hole is sometimes on the bottom of penis. |
|
|
Term
| What are obstructive Uropathies? |
|
Definition
| Congenital anomalies that interfere with urine flow (stenosis). They all result in hydronephrosis and eventually chronic renal failure. |
|
|
Term
|
Definition
Ureteopelvic junction (UPJ) obstruction
Posterior urethral valves (PUVs)
Prune-belly syndrome |
|
|
Term
| What are complications with prune belly syndrome? |
|
Definition
Also known as Eagle Barrett syndrome
1. No abdominal muscles (or very weak)
2. Abnormalities in urinary tract
3. Testes don't come down |
|
|
Term
| How are Uropathies diagnosed? |
|
Definition
| Prenatally with ultrasound |
|
|
Term
| What is the corrective surgery for Uropathies? |
|
Definition
| Pyloplasty, remove obstructed section and replant |
|
|
Term
| What are considerations for Uropathies? |
|
Definition
Watch I/O
No contact sports for kids
Wound care
Watch catheter |
|
|
Term
|
Definition
| When the foreskin of the penis is too tight and does not retract |
|
|
Term
| What are considerations for phimosis management? |
|
Definition
| Teaching involving treatments |
|
|
Term
| What is the medical treatment for phimosis? |
|
Definition
| betamethasone, thins the skin |
|
|
Term
| What is the surgical treatment for phimosis? |
|
Definition
|
|
Term
|
Definition
| When the testicles do not descend |
|
|
Term
| What is the normal time for the testicles to descend? |
|
Definition
| around 7th or 9th month in gestation, latest 3 months |
|
|
Term
| What risks are associated with cryptorchidism? |
|
Definition
| risk for testicular cancer increases by 30% |
|
|
Term
| What are considerations for cryptorchidism? |
|
Definition
Pain control
discharge teaching
no riding toys for 2 weeks
teach the mom not to hold child on hip |
|
|
Term
| What is an inguinal hernia? |
|
Definition
| When the intestines protrudes through the inguinal canal |
|
|
Term
| What is the risk with inguinal hernias? |
|
Definition
| Incarceration: when the intestine cannot be pushed back because the muscle tightens on the bowel |
|
|
Term
| What is the name of the surgery that fixes cryptorchidism? |
|
Definition
| Orchiopexi, wait until one year, painful |
|
|
Term
| What is the tx for inguinal hernias? |
|
Definition
Put in Trendelenburg postion & try to push back out
24-48 hours to get them into surgery |
|
|
Term
| What are considerations for inguinal hernias? |
|
Definition
Pain management
wound care
discharge teaching
no heavy lifting |
|
|
Term
|
Definition
| When there is a rotation in the spermatic cord that restricts blood flow |
|
|
Term
| What is the severity of testicular torsion? |
|
Definition
| It is a medical emergency: 4-6 hour window to restore blood flow to the testis, discharged home within hours after surgery |
|
|
Term
| What are considerations for testicular torsion? |
|
Definition
No stressful activity for 2 weeks
No heavy lifting for 4 weeks
Pain management
wound care |
|
|
Term
| What are symptoms of testicular torsion? |
|
Definition
| Pain, swelling, nausea & vomiting, redness |
|
|
Term
|
Definition
| Fluid in the scrotum, looks shining full of fluid, can be seen with flashlight, result of pushing from pregnancy |
|
|
Term
| What is the tx for hydrocele? |
|
Definition
| none until 1 year, then surgery |
|
|
Term
|
Definition
| A curvature of the penis due to tight tissue, (ET finger) surgically relased |
|
|
Term
| What are the types of bacteriuria UTIs? |
|
Definition
Symptomatic
Asymptomatic
Both greater than |
|
|
Term
| What are the symptoms of a UTI? |
|
Definition
| Dysuria, hematuria, Pain, Fever |
|
|
Term
| How do you figure Dysuria in a baby? |
|
Definition
| Check diaper often, if they have pain and then have |
|
|
Term
| What is important to know about recurrent UTIs? |
|
Definition
| There should be a full work up done, for males the first UTI a work up may be warranted |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Upper part of the tract and kidneys that are infected |
|
|
Term
| What are signs of Urosepsis? |
|
Definition
| Fever, UTI, systemic signs, WBC increase, bacteria in the blood |
|
|
Term
| What is a persistent UTI? |
|
Definition
| UTI that still exists despite antibiotic tx |
|
|
Term
|
Definition
| A febrile UTI implies it is starting to becoming pyelonenephritis |
|
|
Term
| Who is the most susceptible to UTIs? |
|
Definition
| Females 2X as likely as males but uncircumcised males 4x as likely as circumcised |
|
|
Term
| What is the most common cause of UTI? |
|
Definition
E. coli
Then Proteus, psuedomonas, klebsiella, staph aureas, Haemphilus |
|
|
Term
| What is associated with a UTI? |
|
Definition
|
|
Term
| Why does chronic constipation cause UTIs? |
|
Definition
|
|
Term
| What are the peak ages for a UTI? |
|
Definition
|
|
Term
| Why are girls more prone to UTIs? |
|
Definition
When the female urethra closes, the valves flip urine back into the bladder
Shorter urethra
Male prostate secretions are antibacterial |
|
|
Term
|
Definition
| Pus in the urine; only 50% with UTIs will have this but it can also be from bubble baths |
|
|
Term
| What are other causes of UTIs? |
|
Definition
|
|
Term
| What are the medications for a UTI? |
|
Definition
Ampicillin, gentamycin, Allergic to amp-> ceftriaxone,
Chronic: ciprofloxacin, septra (3 mos) |
|
|
Term
| What could it mean if a child has delayed growth? |
|
Definition
|
|
Term
| If an infant has a UTI what do automatically assume? |
|
Definition
|
|
Term
| What are teaching points for preventing UTIs? |
|
Definition
Use a doll
Go to the bathroom when they have to go
Drink cranberry juice
Avoid constipation
Teens should void after intercourse
Clean from front to back
Hydrate |
|
|
Term
| What could a smelly diaper that only contains urine mean? |
|
Definition
| UTI, baby urine should not smell |
|
|
Term
| Why does nitrite mean positive for bacteria on UA? |
|
Definition
| Bacteria turn nitrates to nitrites |
|
|
Term
| What are expected nursing outcomes for UTI patients? |
|
Definition
Child increases fluid intake & number of times voiding each day
Future UTIs are prevented |
|
|
Term
| What medications delay growth? |
|
Definition
| Steroids; cause moon face, hump back, weight gain, small stature |
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