Pediatric Genitourinary Disorders. Enuresis. Repeated involuntary voiding or incontinence by a child past the age of toilet training. about 5-6 years of age. Enuresis Multitreatment Approach. Fluid Restriction Bladder exercises Timed voiding Enuresis alarms
Repeated involuntary voiding or incontinence by a
child past the age of toilet training.
about 5-6 years of age
All are causative agents, Escherichia coli is the more common cause of first time UTI’s.
done every 2-3 months
- regarding prevention of UTI,
- importance of taking all antibiotics, continue
takingantiseptics even when have no symptoms.
Hypospadius / Epispadius
Failure of one or both of the testes to descend from abdominal cavity to the scrotum
testes are in the scrotal sac?
Diagnosed on Newborn Physical Exam
Palpate the testes separately between thumb and forefinger, with thumb and forefinger of other hand over the inguinal canal.
the uretheral opening is on the
lower aspect of the penis and not
on the tip.
Usually discovered during
Newborn Physical Assessment
a. children will experience less pain
b. chordee may be reabsorbed
c. the child has not developed body image
and castration anxiety
d. the repair is easier before toilet training
1. Assess bleeding - Bleeding is controlled post-operatively by the use of pressure dressings. However, a small amount of bleeding for the first several days post-operatively is normal. A few drops of blood or a spot no larger than a quarter on the diaper is acceptable.
2. Maintain urinary drainage – care for catheter – foley / suprapubic, or urethral stent. Use double diapering.
A double diapering technique protects the urinary stent after surgery. The inner diaper collects stool and the outer diaper collects urine.
4.Control Pain – may be given Tylenol
5. Increase fluids intake – assists in
maintaining hydration and free flow of urine.
6. Do not allow to play on any straddle toys.
7. Prevent infection – no bathing or swimming until
8. Call Dr if:
Immune-complex disease which causes inflammation of the glomeruli of the kidney as a result of an infection elsewhere in the body.
and scarred, and slowly lose their
ability to remove wastes and excess
water from the blood to make urine.
a. Moderate Proteinuria
b. Sudden onset of hematuria (tea-colored, reddish-brown, or smoky) and next develops oliguria
c. Excessive foaming of urine
a.Encephalopathy (headache, irritability,
convulsions, coma-from cerebral edema)
a. normal blood pressure, diarrhea
b. periorbital edema, grossly bloody urine
c. severe, generalized edema, ascites
d. severe flank pain, vomiting
Urinalysis- protein (moderate), RBC's, WBC's, Specific Gravity elevated.
*All children should have a urinalysis 2 wks after strep infection.
1. Depends on the severity of the disease. No
specific treatment. Bedrest encouraged. Disease
2. Treat at home if normal BP & adequate output.
3. Must be hospitalized if:
does not exceed maximum intake ordered.
presence of proteinuria and hematuria.
a. fluid volume excess
b. risk for impaired skin integrity
c. risk for injury
d. activity intolerance
When teaching parents about known
antecedent infections in acute
glomerulonephritis, which of the following
should the nurse cover?
A. Herpes simplex
Chronic renal disorder in which the basement membrane surfaces of the glomeruli are affected, causing loss of protein in the urine.
The glomeruli membrane has increased permeability permitting albumin and protein to pass through the membrane and excreted in the urine.
Note the contrast between the normal glomerular anatomy and the changes that exist in nephrotic syndrome permitting protein to be excreted in the urine.
Four most common characteristics:
1. Edema- May have periorbital edema
upon rising in morning and shifts
during the day.
2. Massive proteinuria and hypoproteinemia
a. gross hematuria, proteinuria, fever
b. hypertension, edema, fatigue
c. poor appetitie, proteinuria, edema
d. body image change, hypotension
Answer = C
first morning void to assess for proteinuria. Urine
appears dark and frothy.
cholesterol and triglycerides, elevated hgb, hct,
1. Administer medications – assess for side effects
2. Prevention of infection – avoid people with infections.
May be placed on protective isolation.
3. Keep accurate record of I&O. Measure abdominal girth, weigh daily.
4.Test urine for protein and specific gravity to see if treatment is effective
6. Promote rest
7. Discharge teaching