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Pediatric Renal and Respiratory Flashcards
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Pediatric Renal and Respiratory Flashcards
test 5
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1
Question
What role does a nephrologist play in managing dialysis?
Answer
A nephrologist manages dialysis to ensure numbers (such as lab values) are in check and can consult a urologist if needed.
2
Question
What are the main duties of a urologist related to the urinary tract?
Answer
A urologist looks at the structures of the urinary tract and performs surgeries such as removing tumors on kidneys.
3
Question
If a patient has their kidney removed and later has complications, which specialist should they contact?
Answer
The patient should call their urologist for complications following kidney removal.
4
Question
What is exstrophy of the bladder and what are the care considerations?
Answer
Exstrophy of the bladder is when the bladder forms outside the body. It poses risks for infection and injury. Care involves laying the baby supine, keeping moist sterile dressings on until surgery, which usually occurs in the first week of life.
5
Question
What condition is described by the urethral meatus being located on the top of the penis, and what are some treatment considerations?
Answer
This condition is epispadias. Treatment includes using foreskin to cover the new meatus, creating a new meatus, delaying circumcision to 6 months to 1 year, and incontinence may persist.
6
Question
What causes damage to the kidney due to urine reflux, and what condition results?
Answer
Urine reflux causes urine to back up into Bowman's capsule, damaging the glomerulus and increasing pressure. This damage is called hydronephrosis and is commonly seen in children with neurogenic bladder.
7
Question
What does 'enuresis' refer to and what factors can contribute to it?
Answer
Enuresis is incontinence past the age of being potty-trained, usually occurring at night in children. It can be caused by traumatic events and may require therapy if psychological factors exist.
8
Question
What interventions help improve childhood enuresis?
Answer
Interventions include maintaining a voiding journal, limiting fluids and caffeine at night, voiding retraining, and if unsuccessful, consulting a pediatrician about possible constipation.
9
Question
Describe the steps involved in collecting a clean catch urine sample.
Answer
1. Keep labia spread open and urinate a small amount into the toilet, then stop urine flow. 2. Hold urine cup a few inches from urethra and urinate until half full. 3. Finish urinating into the toilet.
10
Question
What is the primary cause of urinary tract infections (UTIs) in children?
Answer
The primary cause is E. coli entering the urinary tract, often from poor hygiene like wiping back to front and holding urine. Girls are at higher risk due to a shorter urethra closer to the anus.
11
Question
What are common signs and symptoms of a urinary tract infection?
Answer
Symptoms include burning or stinging during urination, urgency to urinate, increased frequency, and polydipsia which may be evaluated to check for bladder problems or diabetes.
12
Question
List methods to prevent urinary tract infections (UTIs).
Answer
Prevention includes hygiene education, changing clothes regularly, drinking plenty of fluids to flush the urethra, frequent bathroom breaks, and avoiding irritants like baths with bubbles or scents, especially for girls.
13
Question
Why do uncircumcised males have a greater risk of UTIs?
Answer
Uncircumcised males may have urine that does not flow out as easily, increasing bacterial risk and the chance of infection.
14
Question
What type of urine collection method is typical for infants?
Answer
A urine collection bag, which can be used with or without a diaper, is typical for infants.
15
Question
What is nephrotic syndrome and what alteration causes it?
Answer
Nephrotic syndrome is an autoimmune disease caused by an alteration in the glomerular membrane, leading to increased protein loss in urine and associated symptoms.
16
Question
What are characteristic signs and treatment principles for nephrotic syndrome?
Answer
Signs include edema starting around the eyes spreading to extremities, increased BUN and creatinine, darker urine, and decreased glomerular filtration rate. Treatment includes corticosteroids and a high protein, low sodium diet.
17
Question
What is the #1 complication of nephrotic syndrome, and its signs?
Answer
Peritonitis is the primary complication, caused by fluid shifts. Signs include a tight, painful, hot abdomen and ascites. Infection symptoms require hospitalization.
18
Question
What types of foods are recommended as high protein and low sodium for kidney disease management?
Answer
High protein foods include lean meat, eggs, dairy, beans, lentils, and seafood. Low sodium foods include fresh or frozen meats, eggs, low-sodium peanut butter, dry peas and beans (not canned), and low-sodium canned fish.
19
Question
What causes glomerulonephritis?
Answer
It occurs when streptococcal antigens and antibodies clump together and lodge in the glomerulus, causing inflammation.
20
Question
What is the main treatment for glomerulonephritis?
Answer
The primary medication is antibiotics since streptococcal infections cause it.
21
Question
Compare acute glomerulonephritis (AGN) and nephrotic syndrome (NS) in children.
Answer
AGN is an abrupt immune reaction, common in children 5–10 years, with bloody urine, mild edema, marked hypertension, and lasts 2–3 weeks. NS is chronic, idiopathic, involves massive proteinuria and edema, mild hypertension, marked hyperlipidemia, mainly in children 2–3 years old, treated with bed rest and corticosteroids.
22
Question
What is required for hemodialysis in children and what precautions apply?
Answer
A central line with two ports, usually inserted in the subclavian vein, is required and should not be used for IV access. It may be used for up to a year before switching dialysis types is considered.
23
Question
What is the catheter used for peritoneal dialysis, and how does the process work in infants?
Answer
A Tenckhoff catheter is used, placed into the abdomen. The infant keeps dialysis fluid in the abdomen overnight, and the caregiver drains it out in the morning. This allows more family freedom but increases caregiver responsibility.
24
Question
Describe the evaluation of an arteriovenous fistula for dialysis.
Answer
A fistula connecting an artery and vein should have a palpable thrill (cat purring). If no thrill is felt, listen for a bruit. Absence of both indicates occlusion requiring nephrologist intervention. Blood pressure should never be taken on the fistula side.
25
Question
What is the primary concern for patients on dialysis?
Answer
Infection is the primary concern, and it is important to monitor if the patient is producing urine.
26
Question
What is the most common cause of acute renal failure in children related to E. coli?
Answer
Hemolytic uremic syndrome (HUS) caused by E. coli diarrhea is the leading cause.
27
Question
What are the typical signs and symptoms of hemolytic uremic syndrome?
Answer
Symptoms include bloody, watery, mucusy diarrhea, vomiting, widespread purpura (large red skin spots), and pallor.
28
Question
What is cryptorchidism?
Answer
Cryptorchidism is the failure of one or both testicles to descend into the scrotum.
29
Question
How do you assess for cryptorchidism?
Answer
By palpating the scrotum. A flat scrotum with testicles palpable in the inguinal canal suggests undescended testicles.
30
Question
What is testicular torsion and why is it an emergency?
Answer
Testicular torsion is twisting of the testicle cutting off blood flow, causing severe pain and potential necrosis within two hours. It requires immediate surgery.