Lecture 12 GU
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. What would you like to do?
What is the most common GU tract defect
What are some lab tests to determine renal function
- Uric acid
- BUN/CRE ratio
What is the cause of 80% of UTIs?
E. coli (due to wiping back to front)
What are S/S of a UTI
- frequent urination
- painful urination
- s/s of dehydration
- foul, concentrated urine
- poor feeding, lethargy
what is the best way to obtain a specimen for a urine culture
clean catch (wipe with wipes then void in cup)
How do we treat a UTI
- antibiotic therapy
- fluid maintenance
- collect specimens as ordered
- education (prevention)
What is the common peak age for onset for glomerulonephritis?
- 6-7 years
- twice as common among males than females
What is the most common cause of glomerulonephritis?
Group A beta-hemolytic streptococcus (untreated strep goes to blood stream and to kidneys)
If patient comes in with s/s of UTI and they had strep throat a couple of weeks ago, what do you expect?
What are the S/S of glomerulonephritis?
- Edema (especially periorbital)
- facial edema (more prominent in am)
- Urine is cloudy, smoky brown
- mild to moderately elevated BP
How are we going to treat glomerulonephritis?
- may have fluid restriction
- moderate sodium restriction
- restriction of potassium rich foods
- may get antibiotics
- monitor lab values
What is happening in nephrotic syndrome?
- hyperalbuminuria (or proteinuria)
- initially unexplained hyperlipidemia
- body fluid balance shift (edema, ascites, hypovolemia)
What are the s/s of nephrotic sydrome
- Weight gain
- facial edema (bad during am and subsides during the day)
- generalized edema
- lethargic, easily fatigued
- BP normal or slightly decreased
- frothy urine
- may have diarrhea
how are we going to treat nephrotic syndrome
- dietary changes (low sodium diet)
- meds (corticosteriods and diuretics)
- monitor I/O
You are a nurse in a pediatric emergency room. Around 5 PM, a 3-yr old child is admitted to your care for lethargy, irritability, decreased urine output, and (per the parents) "looking a little puffy". On your assessment, you note that the patient's "puffiness" (edema) is not significant, but the parents state that it was really bad in the morning.The patient's urine, on inspection, is dark amber-colored but clear, and there really isn't a significant quantity of it. You find that the urine is positive for protein.Vital signs are as follows: HR 136 (normal 80-100), BP 124/85 (normal 90-110/60-70), T 100.1° F. Based on these findings, you suspect that your patient likely has
T or F: If caught early enough, the patient with nephrotic syndrome has a good prognosis for recovery.
Your 6 year old patient presents with edema, irritability, and waxy pallor. Mom states that his clothes seem to be getting too tight on him quickly after she buys them. Urinalysis shows a high level of protein and frothy urine. Albumin level is 3.2 g/dL (normal 4-5.8 g/dL for children). B/P is 90/65 (normally 105/70). Your patient is most likely experiencing which of the following?
Patients with BPH (Benign Prostatic Hyperplasia)
should be discouraged from taking which of these medications because they can lead to acute urinary retention?
What does not predispose the child to UTIs?
lower urine pH
In a nonpotty-trained child with nephrotic syndrome, the best way to detect fluid retention is to:
weigh the child daily
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse's reply should be based on knowledge that:
Acute hypertension must be anticipated and identified.
Acute glomerulonephritis would most likely be suspected if the child presented with the clinical manifestations of:
Edema, hematuria, and oliguria
The nurse caring for the child with glomerulonephritis would expect to:
weight the child daily
Clinical manifestations of nephrotic syndrome include
hyperlipidemia, hypoalbuminemia, edema and proteinuria
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