Peds test #2 - Renal system

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  1. functions of the kidneys
    maintains constant composition & volume; produces erythropoietin; produces renin
  2. the primary responsibility of the kidneys is to:
    maintain the composition/volume of the body fluids in equilibrium
  3. functional unit of kidney
  4. rate at which blood is filtered into Bowmann's capsule
    Glomerular Filtration Rate (GFR)
  5. drains Bowman's capsule
    proximal convoluted tubule
  6. urine is concentrated
    Loop of Henle
  7. relatively impermeable to water
    distal convoluted tubule
  8. final concentration of urine
    collecting duct
  9. Low set ears are often associated with ____ abnormalitities
    GU abnormalities
  10. Glomerular filtration and absorption do not reach adult values until ___ to ___ years old
    1 to 2
  11. Urinary tract infection is more common in what gender?
  12. Dysuria, frequent urination, urgency, suprapubic discomfort/pressure, abdominal/flank pain are symptoms of what?
    Urinary tract infection
  13. Pediatric manifestations of UTIs
    Frequency, fever, odiferous urine, blood in urine
  14. Nursing assessment of UTI's include assessing for:
    nausea, vomiting, anorexia, chills, nocturia, urinary frequency, urgency

    Also: suprapubic/lower back pain; bladder spasms, dysuria, buring on urination
  15. Objective data for UTIs
    fever, hematuria, foul-smelling urine, tender, enlarged kidney; leukocytosis, bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan, IVP
  16. ph is normally ___ to ___
    5 to 8
  17. Specific gravity:
    1.001 to 1.030
  18. Protein should be less than ?
    20 mg/dL
  19. Urobilinogen up to ?
    1 mg/dL
  20. newborn production of urine is about ___ to ___ mL/kg/hour
    1 to 2
  21. Child production is about ___ mL/kg/hr
  22. ___ tract infection involves renal parenchyma, pelvis, ureters; typically causes fever, chills, flank pain
  23. ___ tract involves lower urinary tract; usually no systemic manifestations
  24. Classification of lower UTI's
    Cystitis; urethritis
  25. Upper tract classification:
    Pyelonephritis, VUR, glomerulonephritis
  26. bacteriuria despite antibiotics
    persistent UTI
  27. indicates pyelonpehritits
    febrile UTI
  28. bacterial illness; urinary pathogens in blood
  29. Nursing considerations for UTIs:
    teach use of antibiotics; adequate fluid intake; avoid caffeine; good hygiene; prevention
  30. Retrograde flow of bladder urine into ureters; increases potention for infection
    Vesicoureteral reflux
  31. results from a congenital anomaly that affects the ureterovesical junction
    primary reflux
  32. result of an acquired condition
    secondary refulx
  33. inflammation caused by bacteria, fungi, protozoa, or viruses infecting kidneys
    Acute pyelonephritis
  34. Systemic infection from urologic source; can lead to septic shock and death in 15% of cases
  35. N/V, anorexia, chills, nocturia, frequency, urgency, suprapubic/low back pain, dysuria, fever, hematuria, foul-smelling urine are presenting symptoms of:
    acute pyelonephritis
  36. ____ may be used for recurrent acute pyelonephritis
  37. Symptoms of glomerulonephritis:
    Generalized edema, oliguria, HTN due to ECF, hematuria, proteinuria
  38. noninfectious renal disease (autoimmune); onset 5 to 12 days after other infection; most commin in children 6 to 7 years old; hemolytic streptococci
    Acute Post Streptococcal Glomerulonephritis
  39. ASPG will have increased what? (Diagnosic tests)
    BUN, creatinine, ASO titers, C-reactive protein
  40. manage edema of APSG by:
    accurate I&O, daily weights, daily abdominal girth
  41. Nutrition for APSG:
    low sodium, low to moderate protein
  42. Most common presentation of glomerular injury in children
    Nephrotic Syndrome
  43. 5 characteristics of Nephrotic Syndrome:
    Proteinuria, hypoalbuminemia, hyperlipidemia, edema, masive urinary protein loss
  44. With nephrotic Syndrome, the glomerular membrane becomes:
    permeable to proteins, especially albumin
  45. Fluid shifts in nephrotic syndrome from plasma to interstitial spaces, causing:
    Hypovolemia, ascites
  46. Diet for nephrotic syndrome management:
    Low to moderate protein, sodium restrictions
  47. Drugs used for nephrotic syndrome management
    Steroids (prednisone), immunosuprressant therapy (Cytoxan), Lasix, Albumin
  48. Some side effects of Cytoxan include:
    Leukopenia, severe nausea/vomiting, loss of hair, sterility in males
  49. 3 major nursing inverventions for nephrotic syndrome:
    Prevent infection, ensure adequate fluid intake, discharge to home instructions
  50. a protrusion of a portion of an organ through an abnormal opening
  51. 80% of hernias are what type?
  52. Manifestations of inguinal hernia includes:
    partial obstruction of intestines, incarceration, strangulation, gangrene
  53. Presence of fluid in processus vaginalis
  54. Scrotum appears enlarge, especially after activity in childhood; surgical repair in some cases
  55. Narrowing of stenosis of preputial opening of foreskin, preventing retractin of foreskin over the glans
  56. Normal in infants/young children, usually disappears as child grows
  57. Inflammation of foreskin
  58. retracted foreskin cannot be replaced to normal position
  59. Expect natural retraction of foreskin in what age?
    5 to 10 years
  60. undescended, retractile, abcense of testes (33% in preterm males, 3 to 4% in full-term males)
  61. prevents damage to undescended testes; decreases incidense of malignant formations; avoid trauma/torsion
  62. Urethral opening of male is located below the glans or underneath the penile shaft/ about 1 out of 300 live births
  63. ventral curvature of the penis; foreskin may be absent ventrally; hooded or crooked appearance of penis
  64. Severe defect with externalization of the bladder and associated tissues
    Epispadias exstrophy complex
  65. Results from failure of abdominal wall to fuse in utero
    epispadias exstrophy complex
  66. failure of uretheral canalization
  67. defect on the dorsal surface of the penis
    Glandular Epispadias
  68. Therapeutic goals of epispadias management (5)
    Preserve renal function, attain urinary control, repair for psychologic benefit, prevent UTIs, preserve optimum external genitalia with continence and sexual function
  69. Correction of exstrophy of the bladder, correct pelvic diastasis, correct hernias is stage __ of surgery of epispadias exstrophy complex
  70. Repair of epispadias and creation of urethral sphincter is stage ___ of surgery of epispadias exstrophy complex
  71. 3 nursing considerations for epispadias exstrophy complex:
    Challenging preoperative care, prevent infection, family support for emotional impact of the defect
  72. Clinical manifestations of obstructive uropathy: (5)
    Depends on location of lesion; may be asymptomatic; may cause UTIs; may have abdominal mass; may produce "renal colic"
  73. therapeutic management of obstructive uropathy:
    Transient/permanent urinary diversion in some situations; endoscopic procedures; prognosis variable depending on the defect
  74. abnormalities of chromosomal complement; defects of embryogenesis; hormonal/biochemical abnormalities
    Ambigous Genitialia
  75. 4 conditions that produce ambigious genitalia in the newborn:
    masculinized female; incompletely masculinized male; presence of male and female organs; mixed gonadal dysgensis
  76. Most common type of ambiguous genitalia; inherited deficiency of adrenal-cortical hormones, masculinization of external genitalia with normal internal female anatomy, life threatening alteration of adrenal-cortical hormones
    Congenital Adrenogenital Hyperplasia (CAH)
  77. Potential Causes for masculinized male:
    Deficient production of fetal androgen; deficiency of enzymes needed for testosterone biosynthesis; unresponsiveness of genitalia to testosterone
  78. Infants are sex chromosome mosaics; genitalia vary greatly; those appearing predominately female but have dysplastic testis may experience masculinization at puberty
    Mixed Gonadal Gysgenesis
  79. The most significant ongoing assessments in children with renal conditions are accurate measurement/recordings of (4)
    Weight, Intake, Output, BP
  80. failure of 1 or both testes to descend normall through the inguinal canal into scrotum
  81. Occurs when connection between kidney and ureter is blocked, urine cannot flow out of the kidney, which causes kidney to swell
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Peds test #2 - Renal system
Peds test #2
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