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Peds chp 15
fluid balance, renal, and reproductive disorders
| Question | Answer |
|---|---|
| this occurs when fluid output exceeds fluid intake, regardless of the cause. | Dehydration |
| when fluid intake and output are in balance | homeostasis |
| immature infant kidneys equals | poor water conservation |
| ____ are subject to greater evaporation of water from skin | infants |
| rapids respiration's will ______ fluid loss | increase |
| classification of dehydration is based on what? | serum sodium levels, isotonic,hypotonic,hypertonic |
| type of fluids given by route other than digestive tract | parenteral fluids |
| when body receives more fluids then it can excrete | overhydration |
| presence of fluid in the interstital spaces | edema |
| edema in infants may first be seen in these areas | presacral,occipital,genital areas |
| bacterial invasion of the kidneys,ureters,bladder and urethra | urinary tract infection |
| risk factors for uti's | urinary stasis, urinary tract anomalies, reflux in the tract system,tight undearwear,wet bathing suits, sex |
| s/s of urinary tract infections | poor feeding, fussiness, delayed growth, foul smelling urine, incontinence |
| many girls may have these classic uti s/s after first sexual experience | frequency, urgency, pain on urination, blood in the urine |
| these s/s can indicate kidney infection AKA pyelonephritis | high fever, chills, flank pain, abdominal pain |
| nursing teaching for uti | no bubble baths or irritating diapers, wipe front to back, wear cotton underwear,increase fluid intake,dont put off going pee, check for s/s of pinworms |
| treatment for uti | 7-14 day course antibiotic, sulfamethoxazole-septra, trimethoprim-bactrim, or penicillins,cephalosporins |
| occurs as an immune reaction to an infection of the body (antigen-antibody,most common renal disease. mostly seen in kids age 6-7 | acute glomerulonephritis |
| s/s of glomerulonephritis | smokey brown or bloody urine,periorbital edema in morning that spreads as the day goes,fatigue, headache,abdominal discomfort, vomiting, oliguria |
| what is oliguria | decrease in urine output |
| causes of acute glomerulonephritis | certain strains of group a b-hemolytic streptococcal, aka strep throat |
| treatment for acute glomerulonephritis | prevetion from being chilled, over tired, exposure from infection, low sodium, low potassium diet,lasix, persistent anuria may need dialysis |
| refers to the number of different types of kidney conditions that are distinguished by the presence of marked amounts of protein in the urine | nephrotic syndrome aka nephrosis |
| these filter blood in the kidneys, and damage to them allows protein to enter urine | glomeruli |
| s/s of nephrotic syndrome | nausea, vomiting, diarrhea, weight gain, edema, ascites,DARK FROTHY URINE, oliguria, slightly elevated bp |
| treatment of nephrotic syndrome | steriods,diurtics,albumin,low sodium high protein diet,fluid balance with MEASURED urine,skin care,repositioning, infecton control, emotional support |
| what is enuresis | must occur at least twice a week for 3 months and child must be over 5yrs old to be diagnosed with enuresis aka bed wetting |
| child has never been dry for an extended period of time | primary bed wetting |
| bed wetting after the child has been dry for some time | secondary bed wetting |
| treatment for enuresis | never punish,time,meds,fluid restriction after evening meal,bladder training,waking child to void, alarm to signal beds wet |
| chronic or acuteoth illness that can affect enuresis | uti, diabetes,sickle cell, neurologic deficits |
| one or both testes fail to descend into the scrotum | undescended testes |
| side effect of undescended testes | REDUCED FERTILITY due to abdomen being to warm |
| treatment for undescended testes | between 9-15 months a surgical procedure called orchiopexy to bring down in scrotum |
| the opening of the urinary meatus appears on the ventral or underside of the shaft of the penis | hyposadias |
| the urethral opening in on the dorsal or upper side of the shaft of the penis | epispadias |
| treatment for hyposadias or epispadias | surgical repair between 6-12 months old |
| STD are a worry of peds beacuse | teens mature earlier, in gauge in sex earlier, have multiple partners,marring later in life,rate of infection higher in teens |
| dorsal surface of the penis defect | epispadius |
| foreskin defect | phimosis |
| lower abdomen defect | exstrophy of the bladder |
| scrotal sac defect | hydrocele |
| inguinal canal defect | cryptorchidism |
| bottom or ventral surface of penis defect | hypospadias |
| surgery for hypospadias and chordee, my son is only 8 months old, why doesnt the doctor wait until he is older, most appropriate response by nurse...... | children typically become aware of genitalia and gender between ages 3-6, its perferable to do the surgery when they are young enough to protect their self image |
| what objective data should the nurse expect to see with a toddler who has nephrotic syndrome | 3+ to 4+ protein in the urine |
| medications for enuresis | antidiuretics-desmopressin acetate,tricyclic antidepressants- imipramine hydrochloride(tofranil), anticholinergics-oxybutynin chloride(ditropan) |
| MEDS-used to reduce volume of urine in bladder adverse effects,headache, nausea, flushing, fluid retention, mild abdominal cramps,NCT- restrict fluids after dinner,give at bed time,keep nasal meds in fridge | antidiuretics-desmopressin acetate |
| MEDS-reduces bladder contractions adverse effects- dry mouth, nausea, drowsiness, allergic reaction. | anticholinergics-oxybutynin chloride (ditropan) |
| rule of thumb for urine output | 2ml/kg/hr for infants, 0.5 to 1ml/kg/hr for a child |
| a downward curvature of the penis resulting from tight fibrous band usually with hypospadias | chordee |
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