Peds test #2 - Renal system

functions of the kidneys

the primary responsibility of the kidneys is to:

functional unit of kidney

rate at which blood is filtered into Bowmann's capsule

drains Bowman's capsule

urine is concentrated

relatively impermeable to water

final concentration of urine

Low set ears are often associated with ____ abnormalitities

Glomerular filtration and absorption do not reach adult values until ___ to ___ years old

Urinary tract infection is more common in what gender?

Dysuria, frequent urination, urgency, suprapubic discomfort/pressure, abdominal/flank pain are symptoms of what?

Pediatric manifestations of UTIs

Nursing assessment of UTI's include assessing for:

Objective data for UTIs

ph is normally ___ to ___

Specific gravity:

Protein should be less than ?

Urobilinogen up to ?

newborn production of urine is about ___ to ___ mL/kg/hour

Child production is about ___ mL/kg/hr

___ tract infection involves renal parenchyma, pelvis, ureters; typically causes fever, chills, flank pain

___ tract involves lower urinary tract; usually no systemic manifestations

Classification of lower UTI's

Upper tract classification:

bacteriuria despite antibiotics

indicates pyelonpehritits

bacterial illness; urinary pathogens in blood

Nursing considerations for UTIs:

Retrograde flow of bladder urine into ureters; increases potention for infection

results from a congenital anomaly that affects the ureterovesical junction

result of an acquired condition

inflammation caused by bacteria, fungi, protozoa, or viruses infecting kidneys

Systemic infection from urologic source; can lead to septic shock and death in 15% of cases

N/V, anorexia, chills, nocturia, frequency, urgency, suprapubic/low back pain, dysuria, fever, hematuria, foul-smelling urine are presenting symptoms of:

____ may be used for recurrent acute pyelonephritis

Symptoms of glomerulonephritis:

noninfectious renal disease (autoimmune); onset 5 to 12 days after other infection; most commin in children 6 to 7 years old; hemolytic streptococci

ASPG will have increased what? (Diagnosic tests)

manage edema of APSG by:

Nutrition for APSG:

Most common presentation of glomerular injury in children

5 characteristics of Nephrotic Syndrome:

With nephrotic Syndrome, the glomerular membrane becomes:

Fluid shifts in nephrotic syndrome from plasma to interstitial spaces, causing:

Diet for nephrotic syndrome management:

Drugs used for nephrotic syndrome management

Some side effects of Cytoxan include:

3 major nursing inverventions for nephrotic syndrome:

a protrusion of a portion of an organ through an abnormal opening

80% of hernias are what type?

Manifestations of inguinal hernia includes:

Presence of fluid in processus vaginalis

Scrotum appears enlarge, especially after activity in childhood; surgical repair in some cases

Narrowing of stenosis of preputial opening of foreskin, preventing retractin of foreskin over the glans

Normal in infants/young children, usually disappears as child grows

Inflammation of foreskin

retracted foreskin cannot be replaced to normal position

Expect natural retraction of foreskin in what age?

undescended, retractile, abcense of testes (33% in preterm males, 3 to 4% in full-term males)

prevents damage to undescended testes; decreases incidense of malignant formations; avoid trauma/torsion

Urethral opening of male is located below the glans or underneath the penile shaft/ about 1 out of 300 live births

ventral curvature of the penis; foreskin may be absent ventrally; hooded or crooked appearance of penis

Severe defect with externalization of the bladder and associated tissues

Results from failure of abdominal wall to fuse in utero

failure of uretheral canalization

defect on the dorsal surface of the penis

Therapeutic goals of epispadias management (5)

Correction of exstrophy of the bladder, correct pelvic diastasis, correct hernias is stage __ of surgery of epispadias exstrophy complex

Repair of epispadias and creation of urethral sphincter is stage ___ of surgery of epispadias exstrophy complex

3 nursing considerations for epispadias exstrophy complex:

Clinical manifestations of obstructive uropathy: (5)

therapeutic management of obstructive uropathy:

abnormalities of chromosomal complement; defects of embryogenesis; hormonal/biochemical abnormalities

4 conditions that produce ambigious genitalia in the newborn:

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

Potential Causes for masculinized male:

Infants are sex chromosome mosaics; genitalia vary greatly; those appearing predominately female but have dysplastic testis may experience masculinization at puberty

The most significant ongoing assessments in children with renal conditions are accurate measurement/recordings of (4)

failure of 1 or both testes to descend normall through the inguinal canal into scrotum

Occurs when connection between kidney and ureter is blocked, urine cannot flow out of the kidney, which causes kidney to swell