Urinary Dysfunction in Children
Terms
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- General signs and symptoms of urinary tract disorders in neonates include?
-
-FTT, poor feeding, vomit, dehydration
-tachycardia, respiratory distress, seizures
-urinary frequency, enlarged kidney/bladder - General signs and symptoms of urinary tract disorders in infants include?
- -foul-smelling urine, pallor, fever
- General signs and symptoms of urinary tract disorders in a child include?
- -poor appetite, vomit, thirst, enuresis, dysuria, frequency, fatigue, pain, increased B/P
- The single most important test for detection of renal problems is?
- urinalysis
- Most useful estimation of glomerular filtration rate is the clearance of ___.
- creatinine
- Assess for allergies for these 2 urinary diagnostic tests due to injection of contrast medium.
-
1. IVP
2. voiding cystourethrogram - The diagnosis of vesicoureteral reflux (VUR)is made by?
- VCUG
- Complications of VUR include:
- renal scarring, renal hypertension, chronic renal failure
- 3 examples of antibiotics and antispasmodics?
- Atropine, Pyridium, Urimax
- Associated anamolies of exstrophy of the bladder include:
- epispadia, double clitoris, widened symphysis pubis which can cause malrotation of the hips
- 1st stage of surgery for exstrophy of the bladder involves?
- reconstruction of the bladder reservoir
- 2nd stage of surgery for exstrophy of the bladder involves?
- reconstruction of bladder neck and urethra
- Position the patient who has had surgery for exstrophy of the bladder in a ___ position.
- lateral
- FACT:
- In hemolytic uremic syndrome, acute renal failure occurs due to blood clotting in renal arterioles and toxic effect of hemolyzed RBCs.
- Nephrotic syndrome is characterized by (4)...
-
severe edema
proteinuria
hyperlipidemia
hypoalbuminemia - Manifestations of nephrotic syndrome?
-
-weight gain
-ascites
-peripheral, labial, scrotal edema
-anasarca
-anorexia, diarrhea, malnutrition
-respiratory difficulties, (i.e.pulmonary congestion)pallor, fatigue, lethargy
-dark, frothy urine
-increased susceptibility to infection - The loss of ___ is the primary indicator of nephrotic syndrome.
- protein
- Daily loss of protein in nephrotic syndrome is ___.
- 50 mg/kg/day
- Blood studies would show an albumin level less than ___.
- 2 gm dl
- Primary agent for the management of nephrotic syndrome is?
- Prednisone (corticosteroid)
- High doses of Prednisone in children can cause ___.
- growth retardation
- What 4 types of meds are given for nephrotic syndrome?
-
1. corticosteroids (Prednisone)
2. Immunosuppresants (Cytoxan, Leukoran, Neoral)
3. Diuretics (Lasix/Aldactone)
4. Plasma expanders
5. ACE inhibitors for HTN
6. NSAIDs
7. Antibiotics for infection - S/E of immunosuppresants?
- leukopenia, male sterility (>3 months), increases risk of seizure
- The use of immunosuppresants for the management of nephrotic syndrome should be limited to ___.
- 2-3 months
- 3 cardiovascular complications of nephrotic syndrome?
-
1. HTN
2. tachycardia
3. thrombosis - High doses of Prednisone can cause (5):
-
1. *growth retardation
2. cataracts
3. osteomalacia
4. HTN
5. obesity - What are 3 S/S of steroids?
-
1. rounding of the face
2. increased appetite
3. weight gain - Onset of AGN occurs ___ days after strep infection.
- 10-21
- AGN occurs after an infection with ___.
- group a beta-hemolytic strep
- Group a beta-hemolytic strep of the skin causes ___ while group a beta-hemolytic strep of the pharynx causes ___.
- impetigo; pharyngitis
- ___ can cause hypertensive encephalopathy.
- AGN
- Manifestations of AGN:
-
-hematuria/proteinuria; dysuria
-tea-colored urine
-wt.gain, edema, possible oliguria
-perioribtal edema, anasarca
-encephalopathy: H/A, N/V, irritability, fatigue
-azotemia with increased BUN and creatinine
-proteinuria, RBC, WBC, casts
-HTN (mild to moderate)
-anemia, leukocytosis
-Positive anti-streptolysin-O-titer
-Elevated ESR - S/S of complications of AGN:
-
-elevated B/P, H/A, dizziness, abdominal discomfort, vomiting, altered LOC, seizures (hypertensive encephalopathy)
-coughing, restlessness, paroxysmal nocturnal dyspnea (pulmonary edema)
-tachycardia, tachycardia, dyspnea (CHF)
-severe oliguria/anuria - hemolytic uremic syndrome is characterized by (3):
-
1. hemolytic anemia
2. acute renal failure
3. thrombocytopenia - Hemolytic uremic syndrome is usually linked to ___ caused by ___.
- verotoxin; e.coli
- Prodromal stage of hemolytic uremic syndrome is characterized by:
-
-upper respiratory illness, fever, irritability, skin rash
-edema, abdominal pain, N/V, bloody diarrhea - Acute stage of hemolytic uremic syndrome is characterized by:
-
-hemolytic anemia, HTN, pallor, purpura
-neuro (irritability, seizures, altered LOC, hallucinations, cerebral edema, posturing, blindness) - Treat increased phosphorus with ___.
- aluminum hydroxide gel
- Treat decreased calcium levels with ___ or ___.
- calcium gluconate; calcium chloride
- What kind of dialysis is preferred to treat hemolytic uremic syndrome?
- peritoneal
- Diet for the treatment of hemolytic uremic syndrome should be ___ calorie, ___ CHO, ___ PRO, ___ Na, ___ K, ___ Ph
- increased, increased, decreased, increased, decreased, decreased