25 terms

Pediatric genitourinary disorders

Description, s/s and therapeutic management of pediatric genitourinary disorders
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How much urine do infants normally produce
2ml/kg/hr
Enuresis
bed wetting greater than age 5
Characteristics of enuresis
usually boys,older than age 5, 2 or more occurences in a week,urgency,frequency. can be caused by emotional factors or family history
Therapeutic management for enuresis
Bladder training, fluid restriction in evenings, interruption of sleep to void, conditioned reflex response device.
Pharmaceutical management for enuresis
Tofranil, oxybutynin, DDVAP
Urinary tract infection (UTI)
inflammation of the urinary tract most commonly caused by e coli
S/S of UTI
fever, nausea, vomiting, anorexia, chills, nocturia, frequency, urgency. suprapubic or lower back pain, burning or pain upon urination
Conditions that predispose infants and children to UTI
urinary tract obstruction, voiding dysfunction,anatomic differences, susceptibility to infection,reflux (vur), urinary retention while toilet training, bacterial colonization of the prepuce on uncircumsized infants
Pharmaceutical management of UTI
increase fluids, administer atb, bactrim, amoxicillin, cephalexin, gentamycin, carbencillin, pyridium, Urised
Acute pyelonephritis
inflammation caused by bacteria, fungi, protozoa, or viruses infecting the kidneys
Urosepsis
systemic infection from urologic source
Preexisting factor for pyelonephritis
stricture or obstruction of lower urinary tract or VUR
S/S Acute pyelonephritis
nausea, vomiting, anorexia chills,dysuria,suprapubic or low back pain,fever, hematuria, foul smelling urine
symptoms often subside in few days without tx
Therapeutic treatment of Acute pyelonephritis
hospitalization, parenteral atb,
Acute postinfectious glomerulonephritis
a non infectious renal disease that occurs 5-12 days after another type of infection. usually strep (GABHS)
Immune complexes get trapped in glomerular capillary loop and cause trouble
S/S of Acute postinfectious glomerulonephritis
preorbital edema advances to generalized edema, HTN,Oliguria,hematuria,proteinuria Increased potassium, decreased sodium, mild anemia
Therapeutic management of Acute post infectious glomerulonephritis
Daily wts, accurate I& O q 2hr, daily abd girth,assess respiratory status, restrict fluids, B/P q 8 hr, low sodium, low -mod protein,provide rest, reposition q 2hr
How much urine do children normally produce
0.5 - 1ml/kg/hr
Nephrotic syndrome
condition of the kidneys as a result of glomerular injury
S/S Nephrotic syndrome
develops gradually, edema and wt gain,pale irritable, fatigued, decreased urine output, proteinuria (exceeds 50mg/kg in 24hrs),Hypoalbuminemia(<2.5g/dl), hypercholesterolemia (>200mg/dl),
Pharmaceutical management of Nephrotic syndrome
Corticosteroids to decrease proteinuria, Albumin and diuretics to reduce edema and ACE inhibitor to decrease protein excretion
Acute renal failure (ARF)
sudden severe loss of kidney function usually caused by dehydration in children
S/S of ARF
primary symptom is oliguria, metabolic acidosis, azotemiz and electrolyte disturbances
complications of ARF
hyperkalemia, htn,anemia, seizures, hypervolemia and cardiac failure with pulmonary edema
Chronic renal failure (CRF)
loss of kidney function that occurs over time, results in uremia, anemia, hypertension, metabolic acidosis, hyperphosphatemia and/or hypocalcemia