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buckwild
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clues to renal disorders on prenatal US?
oligohydramnios
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primary enuresis?
bedwetting in a child who has never had voluntary bladder control
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secondary enuresis
bedwetting in a child with previous control over bladder
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mgmt of enuresis?
- ^ fluids during day, restrict before bedtime
- routine schedule
- education and support
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DDAVP?
- oral/nasal spray antidiuretic
- not given <6 years
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DDAVP, oxybutynin or imipramide?
enuresis pharm therapies
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most common cause of UTI?
E coli
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most common bacterial infx in children?
UTI
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why is UTI more common in infants/children than older?
shorter urethra
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s/sx of UTIs?
fever, jaundice, poor eating, weight loss
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vesicoureteral reflux?
- backward urine flow from bladder to ureters to renal pelvis
- common in kids with UTI
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long term complications from vesicoureteral reflux?
renal damage
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nursing mgmt of vesicoureteral reflux?
prophylaxis abx, surgical correction, follow up VCUG
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obstructive uropathy?
abnormalities in urinary system that interfere with urine flow
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hydronephrosis?
accumulation of urine in renal pelvis due to obstructed outflow of urine
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post urethral valve
- obstruction that blocks urethra
- clinical emergency
- urine backs up and can cause permanent kidney damage
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ileal conduit?
ureters disconnected from bladder, reattached to ileum
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normal descent of testes when?
7th - 9th month of gestation
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if undescended testes is not corrected, increased risk for..?
testicular cancer
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hypospadias/epispadias?
- hypo - urethral opening on top of penis
- epispadias - urethral opening underneath penis
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contraindication for hypospadias/epispadias?
neonatal circumcision. skin may be used for reconstruction
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acute post-streptococcal glomerulonephritis occurs when?
1-2 weeks after a strep infection
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most common childhood renal disease? peak age?
- AGN (acute post-strep glomerulonephritis)
- age 5-7
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pathophys of AGN?
complex of antigen-antibody is lodged in glomeruli. inflammatory response, reduced renal function.
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how to diagnose AGN?
- throat culture
- *look for elevated antibody titer (antistreptolysin O)
- * elevated erythrocyte sedimentation
- ^ BUN/crt
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important to monitor during AGN?
BP! hypertension common compx
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complications of AGN
- ◦ Severe hypertension *
- ◦ Hypertensive encephalopathy*
- ◦ Seizures*
- ◦ Cardiac decompensation from hypervolemia*
- ◦ Acute renal failure*
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nephrotic syndrome
- autoimmune process 1 wk after immune response
- permeability of membrane is changed (letting more thru).
- proteins spilling into urine
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albumin levels secondary to nephrotic syndrome?
very low. (losing protein)
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hypoalbumenia, proteinuria, hyperlipidemia.. indicators of what?
nephrotic syndrome
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why so much edema with nephrotic syndrome?
- third spacing.
- intravascular fluid -> interstitial space > hypovolemia
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pharm treatment for nephrotic sydnrome?
corticosteroids, IVIG
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