Peds GU.txt

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Peds GU.txt
2012-03-22 10:01:07
nursing genitourinary

genitourinary disorders ing children
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  1. Hypospadias
    urethral opening on ventral/inferior side of penis
  2. Pathology of Hypospadias
    failure of fusion of endoderm edges of the secondary urethral groove to tube
  3. Clinical Manifestations of Hypospadias
    foreskin looks like hood; downward curve; IH and UDT
  4. Diagnosis/Tests for Hypospadias
    Physical Exam
  5. Drugs to Treat Hypospadias
    post-op: nerve block (dorsal or caudal); Tylenol for pain; Anthicholinergics to px bladder spasm associated with urethral stent
  6. Tx of Hypospadias
    surgery <18mths old or before toilet training
  7. Nsg Mgmt for Pts with Hypospadias
    Ax for related abnormalities; pain mgmt; px infection; Ax post-op voiding
  8. Associated Illnesses of Hypospadias
    Peds: IN, UDT, hydrocele, chordee
  9. Epispadias
    urethral opening on dorsal/superior side of penis
  10. Pathology of Epispadias
    unknown pathology
  11. Clinical Manifestations of Epispadias
    urethral opening on dorsal/superior side of penis; bifid clitoris in females
  12. Diagnosis/Tests for Epispadias
    CBC, serum electrolytes, pelvic xray,intravenous pyelogram, urogenital ultrasound
  13. Tx of Epispadias
    surgery (2nd may be needed)
  14. Nsg Mgmt for Pts with Epispadias
  15. Associated Illnesses of Epispadias
    bladder extrophy; incontinence
  16. Phimosis
    inability of the prepuce (foreskin) to be retracted behind the glans penis in uncircumcised males
  17. Pathology of Phimosis
    congenital, or result of scarring and narrowing prenuptial ring from repeated infections
  18. Clinical Manifestations of Phimosis
    bacterial infections; dysuria; ballooning; non-retractive foreskin
  19. Diagnosis/Tests for Phimosis
    Physical exam
  20. Drugs to Treat Phimosis
    antibiotics, anesthesia
  21. Tx of Phimosis
    surgery; manual stretching; stretching under anesthesia; topical steroids; circumcision
  22. Nsg Mgmt for Pts with Phimosis
    educate pt on post-op care
  23. Associated Illnesses of Phimosis
    bacterial infections
  24. Exstrophy of the Bladder
    congenital anomality in which part of the urinary bladder is present outside the body
  25. Pathology of Bladder Exstrophy
    as a fetus, the ab wall and underlying tissue fail to fuse, leaving bladder exposed
  26. Clinical Manifestations of Bladder Exstrophy
    exposed bright red bladder and lower urinary tract; widened symphysis pubis
  27. Diagnosis/Tests for Bladder Exstrophy
    Physical exam
  28. Drugs to Treat Bladder Exstrophy
    low dose antibiotics
  29. Tx of Bladder Exstrophy
    surgery (usually in 1st 48 hours of life); goals: preserve bladder and ab wall, give pelvic support, gain bladder function
  30. Nutritional Considerations for Bladder Exstrophy
    increased water and hi fiber to px constipation
  31. Nsg Mgmt for Pts with Bladder Exstrophy
    includes continence and social mgmt
  32. Associated Illnesses of Bladder Exstrophy
  33. Vesicoureteral Reflux
    backflow of urine in the ureters from bladder to kidneys
  34. Pathology of Vesicoureteral Reflux
    short ureter on inside of bladder doesn't reach in far enough to eject urine, causing backflow
  35. Clinical Manifestations of Vesicoureteral Reflux
    persistent and repeated UTIs; also flank pain, enuresis, ab pain
  36. Diagnosis/Tests for Vesicoureteral Reflux
    cystogram - radiograph of bladder; VCUG (vesicocystoureterogram) - same as cystogram, but while voiding
  37. Drugs to Treat Vesicoureteral Reflux
    antibiotics for long term care; anticholinergics (ditropan) to decrease bladder pressure
  38. Tx of Vesicoureteral Reflux
    drugs first; monitor for s/s of deterioration; surgery if drugs don't work
  39. Nsg Mgmt for Pts with Vesicoureteral Reflux
    educate pt and caregivers on length of tx and drug compliance; maintaining contact with HCP; pre-/post-op surgical care
  40. Associated Illnesses of Vesicoureteral Reflux
    UTIs, enuresis
  41. Hydrocele
    fluid builds up on one or both sides of the scrotum
  42. Pathology of Hydrocele
    processus vaginalis obstructed by intestinal tissue; peritoneal fluid builds up
  43. Clinical Manifestations of Hydrocele
    painless, non-reducible scrotum enlargement; same while crying or coughing
  44. Diagnosis/Tests for Hydrocele
    physical exam; scrotum feels tense; non-reducible
  45. Tx of Hydrocele
    resolves in one year; if not, then surgery
  46. Nsg Mgmt for Pts with Hydrocele
    education on procedure and care; monitor for incarceration, s/s and infection
  47. Cryptochordism
    one or both testes undescended into the scrotum
  48. Pathology of Cryptochordism
    unknown cause; theories include increased ab pressure and hormonal...
  49. Clinical Manifestations of Cryptochordism
    scrotum flaccid and extra small, no movement
  50. Diagnosis/Tests for Cryptochordism
    physical exam; palpation of scrotum and inguinal canal; ultrasound
  51. Drugs to Treat Cryptochordism
    Tylenol and Tylenol #3 for pain (post-op); HCG
  52. Tx of Cryptochordism
    observation, HCG hormone, surgery (orchiopexy) at 1-2 y/o; scrotal fixation
  53. Nutritional Considerations for Cryptochordism
  54. Nsg Mgmt for Pts with Cryptochordism
    caregiver; knowledge deficit; anxiety
  55. Wilm's Tumor
    malignant kidney tumor found most often in children
  56. Pathology of Wilm's Tumor
    rapid growth w/possible metastasis
  57. Clinical Manifestations of Wilm's Tumor
    growth over flank on one side; pain, hematuria, HTN, general malaise
  58. Diagnosis/Tests for Wilm's Tumor
    CT scan, MRI, ultrasound, xray; labs: CBC, urinalysis, blood chemistry, liver function testx
  59. Drugs to Treat Wilm's Tumor
    Chemotherapy drugs: dactinomycin and vincristine
  60. Tx of Wilm's Tumor
    surgical resection, then chemotherapy; radiation as needed
  61. Nsg Mgmt for Pts with Wilm's Tumor
    stay around to answer questions; pain control; monitor I/O; scrotal fixation
  62. Nephrotic Syndrome
    a syndrome characterized by edema and large amounts of protein in the urine and usually increased blood cholesterol
  63. Pathology of Nephrotic Syndrome
    caused by different disorders that damage the kidneys, leading to the release of too much protein in the urine
  64. Clinical Manifestations of Nephrotic Syndrome
    SWELLING all over (eyes, extremities, etc.); increased weight and blood pressure, decreased appetite
  65. Diagnosis/Tests for Nephrotic Syndrome
    Urinalysis (shows increased protein); physical exam; blood work
  66. Drugs to Treat Nephrotic Syndrome
    ACE inhibitors or ARBs, corticosteroids, Vitamin D, diuretics
  67. Tx of Nephrotic Syndrome
    anticoagulants, bring BP to <130/80
  68. Nutritional Considerations for Nephrotic Syndrome
    low salt, low-protein, low cholesterol diet
  69. Nsg Mgmt for Pts with Nephrotic Syndrome
    educate and assist with diet goals
  70. Associated Illnesses of Nephrotic Syndrome
    Kids: minimal change disease; Adults: membranous glomerulonephritis
  71. Enuresis
    uncontrolled urination in children at ages 5-7; symptom, not a disease
  72. Pathology of Enuresis
    organic (physiological); non-organic (exogenous)
  73. Clinical Manifestations of Enuresis
    UTIs, dribbling after voiding, straining, urgent need to urinate, urination caused by laughing
  74. Diagnosis/Tests for Enuresis
    physical exam, family hx, look for abnormalities in abs and genitals; UA, VCUG, urine culture, renal ultrasound
  75. Drugs to Treat Enuresis
    Ditropan (anticholinergic), Tofranil (antidepressant - decreases sleep depth); DDVAP (increase retention)
  76. Tx of Enuresis
    motivational therapy, elimination diet, drugs, bed wetting alarms, bowel programs
  77. Nutritional Considerations for Enuresis
    eliminate soda, artificial drinks, caffeinated drinks, excess sugary foods, citrus fruits
  78. Nsg Mgmt for Pts with Enuresis
    education and support long-term; encourage family to praise improvements; assist family members in voicing feelings
  79. Associated Illnesses of Enuresis
    Adults: incontinence