Term
| Immune complex response to an antecedent beta-hemolytic streptococcal infection of skin or pharynx; antigen-antibody complexes become trapped in the membrane of the glomeruli, causing inflammation and decreased glomerular filtration |
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Definition
| Acute Glomerulonephritis (AGN) |
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Term
| Acute Glomerulonephritis (AGN) nursing assessments |
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Definition
a. recent streptococcal infection
b. mild to moderate edema (often confined to face)
c. irritability/ lethargy
d. hypertension
e. dark-colored urine (hematuria)
f. slight to moderate proteinuria
g. elevated antistreptolysin (ASO) titer, elevated BUN and creatinine
h. oliguria |
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Term
| Nursing diagnoses for acute glomerulonephritis |
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Definition
a. Excess fluid volume related to...
b. Risk for trauma related to... |
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Term
| Nursing Plans and Interventions for Acute Glomerulonephritis |
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Definition
a. monitor: vital signs (especially BP) frequently, I&O, weight, for seizures (hypertensive encephalopathy), for signs of CHF, and for signs of renal failure (uncommon)
b. provide for supportive care
c. provide low sodium diet with no added salt, low potassium, if oliguric
d. administer antihypertensives if prescribed |
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Term
| Decreased urinary output is the first sign of |
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Definition
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Term
| A disorder in which the basement membrane of the glomeruli becomes permeable to plasma proteins; most often idiopathic in nature |
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Definition
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Term
| Nephrotic syndrome usually occurs between the age of |
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Definition
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Term
| Nephrotic syndrome's course may involve exacerbations and |
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Definition
| reissions over several years |
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Term
| Nursing Assessments for Nephrotic syndrome |
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Definition
a. edema that begins insidiously becomes severe and generalized
b. lethargy
c. anorexia
d. pallor
e. frothy-appearing urine
f. massive proteinuria
g. decreased serum protein (hypoproteinemia)
h. elevated serum lipids |
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Term
| Nursing diagnoses for nephrotic syndrome |
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Definition
a. excess fluid volume related to...
b. Imbalanced nutrition: less than body requirements related to... |
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Term
| Monitor the following for Nephrotic Syndrome |
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Definition
| temperature, assess for signs of infection (protect them from infection), and I&O |
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Term
| Provide the following for Nephrotic Syndrome |
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Definition
| supportive care, skin care (edematous areas are vulnerable), bed rest during edematous phase, small frequent feedings of a normal-protein, low salt diet. |
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Term
| For Nephrotic Syndrome, maintain bed rest during |
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Definition
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Term
| Administer the following medications for Nephrotic Syndrome as prescribed |
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Definition
a. steroids such as prednisone and cholinergics such as bethanechol (Urecholine)
b. Cytoxan (used if nonresponsive to prednisone
c. Client is commonly prescribed IV albumin followed by a diuretic |
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Term
Nephrotic Syndrome
Teach the following home care |
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Definition
a. instruct to weigh child daily
b. describe medication side effects
c. describe signs of relapse
d. train to prevent infection |
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Term
| In Nephrotic Syndrome measure abdominal |
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Definition
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Term
| How is the cause Acute Glomerulonephritis different from Nephrotic Syndrome? |
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Definition
| AGN usually follows streptococcal infection; Nephrotic syndrome is usually idiopathic |
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Term
| How is edema different in Acute Glomerulonephritis and Nephrotic Syndrome? |
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Definition
| AGN's edema is usually around the eyes and mild; Nephrotic syndrome's edema is severe and generalized |
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Term
| How is the blood pressure of someone with Acute Glomerulonephritis different from Nephrotic syndrome? |
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Definition
AGN's BP is elevated
Nephrotic Syndrome's BP is normal |
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Term
| How is the urine of a patient with Acute Glomerulonephritis different from that of a patient with Nephrotic Syndrome? |
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Definition
AGN patient's urine is dark, tea colored (hematuria)with slight or moderate proteinuria.
Nephrotic Syndrome patient's urine is dark, frothy yellow with massive proteinuria. |
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Term
| How is the blood of a patient with AGN different from that of a patient with Nephrotic Syndrome? |
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Definition
| AGN patient has normal serum protein and a positive ASO titer; Nephrotic Syndrome patient has decreased serum protein and a negative ASO titer |
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Term
| Bacterial infection anywhere along the urinary tract (most ascend) |
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Definition
| Urinary Tract Infection (UTI) |
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Term
| Nursing Assessment for Infants with UTI |
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Definition
a. vague symptoms
b. fever
c. irritability
d. poor food intake
e. diarrhea, vomiting, jaundice
f.. strong-smelling urine
g. E. choli in urine cultures |
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Term
| Nursing Assessment for older children with UTI |
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Definition
a. urinary frequency
b. hematuria
c. enuresis
d. dysuria
e. fever
f. E. choli in urine cultures |
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Term
| Nursing Diagnoses for Urinary Tract Infection |
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Definition
Impaired urinary elimination patterns related to...
Deficient knowledge (medications) related to... |
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Term
| Suspect and assess for UTI in infants |
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Definition
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Term
| Assess for recurrent UTIs. In infants and young boys a UTI may indicate |
|
Definition
| structural abnormalities of the urinary system |
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Term
| Collect clean voided or catheterized specimen |
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Definition
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Term
| Teach the following for home care of UTIs |
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Definition
a. Instruct to finish all prescribed medications
b. Note that follow-up specimens are needed
c. teach to avoid bubble baths
d. teach to increase acidic oral fluids (apple juice, cranberry juice)
e. instruct to void frequently
f. teach to clean genital area from front to back
g. note symptoms of recurrence |
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Term
| For the renal drug bethanechol (Urecholine) PO, IM, IV the indications are |
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Definition
Cholinergic used to treat
- Urinary retention
- Neurogenic bladder
- Gastric reflux |
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Term
| For the renal drug bethanechol (Urecholine) PO, IM, IV the Adverse Reactions are |
|
Definition
-Orthostatic hypotension
-Flushing
-Asthmatic reaction
-GI distress |
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Term
| For the renal drug bethanechol (Urecholine) PO, IM, IV the Nursing Implications are |
|
Definition
=Do not give IV or IM (may cause circulatory collapse)
-monitor vital signs
-preferably give on empty stomach |
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Term
| For the renal drug Prednisone, PO the indications are |
|
Definition
Adrenocorticosteroid used to treat:
=immunosuppresion (acts as an anti-inflammatory)
-edema (promotes diuresis in nephritic syndrome) |
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Term
| For the renal drug prednisone, PO the adverse reaction are |
|
Definition
-mood changes
-increased susceptibility to infection
- Cushingoid appearance (moon face and buffalo hump)
- acne
-GI distress
-thrombocytopenia
-edema
-potassium loss
-growth failure in children |
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Term
| For the renal drug prednisone, PO the nursing implications are |
|
Definition
a. in children, every other day administration is best to avoid growth failure when drug is taken long term
b. discontinuing this drug requires tapering dose
c. avoid live virus vaccines in children receiving prednisone |
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Term
| The renal drugs Oxybutynin (Ditropan)/PO, transderemal and Tolterodine (Detrol) PO indications are |
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Definition
Genitourinary smooth-muscle relaxants (antispasmodics)used to treat:
-uninhibitied neurogenic bladder
=reflex urogenic bladder
-both are characterized by voiding symptoms of urgency, frequency nocturia, and incontinence |
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|
Term
| The renal drugs Oxybutynin (Ditropan)/PO, transderemal and Tolterodine (Detrol) PO adverse reactions |
|
Definition
Increased susceptibility to UTI
GI distress
Dry eyes
Dry mouth
Vision changes
Dizziness
Chest pain
Drowsiness |
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|
Term
| The renal drugs Oxybutynin (Ditropan)/PO, transderemal and Tolterodine (Detrol) PO Nursing Implications |
|
Definition
a. administered orally available in extended release forms
b. do ot administer with other medicaitons that have anticholinergic effects
c. may exacerbate influx esophagitis
d. contraindicated in clients with untreated glaucoma or any GI narrowing (GI obstruction may occur)
e. safety for use with children has not been established |
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Term
| Result of valvular malfunction and backflow of urine into the ureters (and higher)from the bladder (severe cases are associated with hydronephrosis) |
|
Definition
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|
Term
| Nursing Assessment for vesicoureteral reflux |
|
Definition
a. recurrent UTI
b. reflux (common wiht neurogenic bladder)
c. reflux noted on voiding cystourethrogram (VCUG) |
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|
Term
| Nursing Diagnoses for Vesicoureteral Reflux |
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Definition
a. Risk for infection related to...
b Risk for trauma related to... |
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|
Term
| Teach the following for Vesicoureteral Reflux |
|
Definition
a. Teach home program for prevention of UTI
b. Teach family the importance of medication compliance,which usually leads to resolution of mild cases.
c. Explain the goal of ureteral reimplantation to stop reflux and prevent kidney damage |
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Term
| For Vesicoureteral Reflux monitor postoperative urinary drainage (may be suprapubic or urethral) by |
|
Definition
a. measure output with both catheters
b. assess dressing and incision for drainage
c. restrain child's hands as necessary |
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|
Term
| For vesicoureteral reflux manage these two types of postoperative pain |
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Definition
a. surgical pain
b. bladder spasms |
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Term
| Describe the clean catch method for collecting urine children and infants |
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Definition
a. best obtained using a urine bag to catch the specimen
b. apply from side to side or back to front. Diaper should be applied over the bag.
c. Check child frequently to note urination |
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|
Term
| Describe catheterization for children and infants |
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Definition
| sterile feeding tube is often used to catheterize small children and infants |
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Term
| To collect a sterile urine specimen for infants and children |
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Definition
| In small infants it is best collected by the physician performing a bladder tap. Urine is aspirated through a needle inserted directly into the bladder. The nurse is responsible for makeing sure the infant is appropriately hydrated and restrained during procedure |
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|
Term
|
Definition
| Wilms Tumor (Nephroblastoma) |
|
|
Term
| 4 characteristics of a Wilms Tumor |
|
Definition
a. a Wilms tumor is embryonic in orgin
b. this tumor is encapsulated
c. it occurs in preschool children
d. with early detection, surgery, adjuvant chemotherapy, as well as radiation therapy postoperatively, the prognosis is good. |
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Term
| How does the Wilms Tumor present |
|
Definition
| A mass in the flank area, confined to midline. Often discovered by parents when bathing a child. |
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Term
| Nursing assessments for Wilms Tumor |
|
Definition
a. fever
b. pallor, lethargy
c. elevated blood pressure (excess renin secretion)
d. hematuria (rare) |
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|
Term
| Nursing Diagnoses for Wilms Tumor |
|
Definition
Risk for injury: trauma related to...
Fear related to.... |
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|
Term
| For Wilms Tumor protect child from injury, place a sign on the bed stating |
|
Definition
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|
Term
| For Wilms teaching prepare family for imminent |
|
Definition
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|
Term
| For Wilms Tumor provide the following postoperative care |
|
Definition
a. monitor for increased blood pressure
b. monitor kidney function: I&O, urine specific gravity
c. Provide care for obdominal surgery client -- maintain nasogastric tube and check for bowel sounds
d. support child and family during chemotherapy or radiation therapy |
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|
Term
| Congenital defect of urethreal meatus in males, urethra opens on ventral side of penis behind the glans |
|
Definition
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|
Term
| Surgical correction for hypospadias is usually done before preschool years to allow for the |
|
Definition
| achievement of sexual identity to avoid castration anxiety and to facilitate toilet training |
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|
Term
| Nursing Diagnoses for Hypospadias |
|
Definition
a. Impaired urinary elimination related to ...
b. Disturbed body image related to... |
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Term
| In hypospadias you prepare the child and family for surgery but there is no |
|
Definition
| circumcision prior to surgery |
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|
Term
| For hypospadias assess circulation to the tip of |
|
Definition
| the penis postoperatively |
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|
Term
| For hypospadias, monitor urinary drainage after urethroplasty by checking |
|
Definition
a. foley catheter
b. suprpubic tube
c. urethral stent |
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|
Term
| Teach the following home care for hypospadias |
|
Definition
a. teach care of catheters
b. teach how to empty drainage bag
c. teach prevention of catheter displacement or blockage
d. instruct to increase oral fluids
e. describe signs of infection |
|
|
Term
| Explain the pathophysiology of vescoureteral reflux |
|
Definition
| A malfunction of the valves at the end of the ureters allowing urine to reflux out of the bladder into the ureters and possibly into the kidnesys |
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