Genitourinary Development and Assessment
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Questions and Answers

At what gestational age does urine production begin in utero?

  • 6 weeks
  • 5 months
  • 12 weeks
  • 3 months (correct)

    • What is the normal urine output for infants and toddlers?

  • 1-2 mL/kg/hr
  • 0.5-1 mL/kg/hr
  • 4-5 mL/kg/hr
  • 2-3 mL/kg/hr (correct)

    • Which of the following is NOT considered a warning sign for potential urinary dysfunction?

  • Frequent urination
  • Excessive masturbation
  • Bedwetting
  • Playing sports (correct)

    • Which lab test is commonly associated with assessing kidney function?

    <p>Creatinine</p> Signup and view all the answers

    At what age do kidney functions generally mature?

    <p>2 years</p> Signup and view all the answers

    Which of the following urinary dysfunctions refers to involuntary urination at night?

    <p>Enuresis</p> Signup and view all the answers

    Which imaging test is primarily used to assess the urinary tract?

    <p>IV pyelogram</p> Signup and view all the answers

    What physiological change can occur in infants due to low GFR (glomerular filtration rate)?

    <p>Fluid volume excess</p> Signup and view all the answers

    What condition is characterized by excessive fluid in the sac surrounding the testicle?

    <p>Hydrocele</p> Signup and view all the answers

    What is a potential complication of undescended testes?

    <p>Inguinal hernia</p> Signup and view all the answers

    What is typically the first-line treatment for a patient diagnosed with testicular torsion?

    <p>Immediate surgery</p> Signup and view all the answers

    At what age may spontaneous descent of undescended testes commonly occur?

    <p>4 months</p> Signup and view all the answers

    Which of the following is NOT a part of the care and treatment for undescended testes?

    <p>Encourage swimming immediately after surgery</p> Signup and view all the answers

    Which preventive measure is appropriate for avoiding urinary tract infections in girls?

    <p>Encourage fluids</p> Signup and view all the answers

    What is the approximate bladder capacity of a 4-year-old child?

    <p>6 ounces</p> Signup and view all the answers

    What issue can arise from the administration of prednisone to children with nephrosis?

    <p>Increased risk of infection</p> Signup and view all the answers

    What is the primary issue associated with phimosis?

    <p>Inability to retract the foreskin</p> Signup and view all the answers

    Which condition is characterized by urine leaking from an exposed bladder?

    <p>Exstrophy of the bladder</p> Signup and view all the answers

    What is a significant complication of phimosis?

    <p>Paraphimosis</p> Signup and view all the answers

    At what age is circumcision typically considered to treat phimosis?

    <p>Around 6-12 months old</p> Signup and view all the answers

    Which of the following is a manifestation of obstructive uropathy?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What should be included in the nursing care for an infant with exstrophy of the bladder?

    <p>Cover bladder with plastic shield</p> Signup and view all the answers

    Which risk factor is commonly associated with urinary tract infections in females?

    <p>Having a shorter urethra</p> Signup and view all the answers

    What is the recommended treatment for obstructive uropathy?

    <p>Urinary diversion techniques</p> Signup and view all the answers

    What is the main characteristic of hypospadias?

    <p>Meatus located on the lower shaft of the penis</p> Signup and view all the answers

    What type of urinary infection is characterized by inflammation of the bladder?

    <p>Cystitis</p> Signup and view all the answers

    Which symptoms are characteristic of nephrotic syndrome?

    <p>Massive proteinuria</p> Signup and view all the answers

    What post-operative instruction should be given to parents after hypospadias repair?

    <p>Avoid straddling the infant on the hip</p> Signup and view all the answers

    What should be a priority when caring for a 4-year-old child post-operatively?

    <p>Assurances that appearance and sexual function will not be affected</p> Signup and view all the answers

    Which condition is NOT commonly associated with urinary and reproductive system issues?

    <p>Bacterial vaginosis</p> Signup and view all the answers

    Which of these is an appropriate instruction regarding fluid intake post-hypospadias surgery?

    <p>Increase fluids to ensure hydration</p> Signup and view all the answers

    Which of the following indicates a complication of nephrotic syndrome?

    <p>Increased periorbital edema</p> Signup and view all the answers

    What caution should be taken regarding physical activities after hypospadias repair?

    <p>Avoid tricycle riding as a play activity</p> Signup and view all the answers

    Which of the following is NOT a sign of nephrotic syndrome?

    <p>Positive antistreptolysin titer</p> Signup and view all the answers

    What is the primary purpose of broad-spectrum antibiotics in treatment?

    <p>To prevent infection</p> Signup and view all the answers

    Which of the following is a common clinical manifestation of an allergic reaction to group A beta-hemolytic streptococcal infection?

    <p>Periorbital edema</p> Signup and view all the answers

    What is a key dietary consideration for patients with Minimal Change Nephrotic Syndrome (MCNS)?

    <p>Reduce protein intake</p> Signup and view all the answers

    In which situation should a healthcare provider avoid palpating the abdomen?

    <p>In patients with nephroblastoma</p> Signup and view all the answers

    Which of the following is not a preventive measure against urinary tract infection in children?

    <p>Wearing tight-fitting clothing</p> Signup and view all the answers

    Which is a notable complication that may arise from nephroblastoma?

    <p>Hypertension</p> Signup and view all the answers

    What is a common educational focus for families managing a child with nephrotic syndrome?

    <p>Medication administration and potential side effects</p> Signup and view all the answers

    Which diagnostic measure is typically needed to confirm nephroblastoma?

    <p>IV pyelogram</p> Signup and view all the answers

    What does the urine of a child with a streptococcal infection likely appear as?

    <p>Smoky brown or bloody</p> Signup and view all the answers

    What is an important nursing consideration when managing a patient on steroid therapy?

    <p>Preventing exposure to infection</p> Signup and view all the answers

    Study Notes

    Development of the Urinary Tract

    • Urine production begins in utero, around 3 months gestation.
    • Contributes to amniotic fluid volume (AFV).
    • Kidney function is immature until 2 years old.
    • Low glomerular filtration rate (GFR) increases risk for fluid volume excess and dehydration.
    • Normal urine output:
      • Infants and toddlers: 2-3 mL/kg/hr
      • Children: 0.5-2 mL/kg/hr

    Development of the Reproductive Systems

    • Sex is genetically determined at fertilization.
    • External genitalia are distinguishable by 12 weeks gestation.
    • Sex organs mature during puberty.

    Sexual Abuse

    • Warning signs include:
      • Urinary frequency
      • Excessive masturbation
      • Encopresis
      • Severe nightmares
      • Bedwetting
      • Genital irritation or pain
      • Suggestive posturing
      • Explicit knowledge of sex
      • Decreasing physical or emotional development

    Assessment of Genitourinary Function

    • Reproductive System Assessments: Pap smear, blood tests, cultures, ultrasound, pregnancy tests.
    • Urinary System Assessments: Urinalysis, ultrasound, IV pyelogram, CT scan, renal biopsy, uroflowmetry, cystoscopy, voiding cystourethrography, cystometrogram, urethral pressure.

    Assessment of Genitourinary Function (Common Lab Tests)

    • BUN
    • Uric Acid
    • Creatinine
    • Urinalysis

    Assessment of Genitourinary Function (Urinary Dysfunction)

    • Dysuria
    • Frequency
    • Urgency
    • Nocturia
    • Enuresis
    • Polyuria
    • Oliguria

    Anomalies of the Urinary Tract

    • Phimosis
    • Hypospadias and Epispadias
    • Exstrophy of the Bladder
    • Obstructive Uropathy
    • Acute Urinary Tract Infection
    • Nephrotic Syndrome
    • Acute Glomerulonephritis
    • Wilms' Tumor
    • Cryptorchidism
    • Hydrocele

    Phimosis

    • Narrowing of the preputial opening of the foreskin.
    • Prevents foreskin retraction.
    • Can cause dribbling or irritation.
    • Considered normal up to age 3.
    • Potentially complicated by paraphimosis (foreskin cannot be returned to normal position).
    • Circumcision solves the condition.

    Hypospadias & Epispadias

    • Hypospadias: Urethral opening on the lower shaft of the penis.
    • May be accompanied by chordee.
    • Epispadias: Urethral opening on the upper surface of the penis.
    • Circumcision is avoided when these conditions are present.
    • Surgical repair typically between 6-12 months of age.

    Exstrophy of the Bladder

    • Lower abdominal wall and part of the bladder wall missing.
    • Bladder lies open.
    • Urine continuously leaks.
    • Surrounding skin becomes excoriated.
    • Urgent surgical closure within 48 hours of life.

    Obstructive Uropathy

    • Obstruction of normal urine flow.
    • Can be congenital or acquired.
    • May be partial or complete.
    • Can affect one or both kidneys.
    • Can be complicated by hydronephrosis, polycystic kidney disease, metabolic acidosis, and UTI.
    • Treatment options include urinary diversion (ureterostomy, ileal or colon conduit, nephrostomy, suprapubic tube placement, vesicostomy).

    Acute Urinary Tract Infection (UTI)

    • Risk factors for males: uncircumcision in newborns
    • Risk factors for females: short urethra, proximity of urinary meatus to rectum, tight clothing, bubble baths
    • Types of infections: urethritis, cystitis, bacteriuria, pyelonephritis, ureteritis, vesicoureteral reflux.
    • Alkaline urine favors pathogens

    Nephrotic Syndrome

    • Marked proteinuria (protein in urine).
    • Edema
    • Hypoalbuminemia
    • Minimal Change Nephrotic Syndrome (MCNS) is a common form.
    • Steroid therapy is often the treatment.

    Acute Glomerulonephritis

    • Allergic reaction to group A beta-hemolytic streptococcal infection (e.g., strep throat, scarlet fever, skin infections).
    • Can cause brain ischemia and cardiac toxicity.

    Wilms' Tumor

    • Malignant renal tumor.
    • Encapsulated tumor compressing kidney tissue
    • Often discovered by age 3.
    • IV pyelogram to confirm growth.
    • May be complicated by hypertension (high blood pressure).

    Hydrocele

    • Excessive fluid in the sac surrounding the testicle.
    • Often resolves by 1 year of age.
    • May require surgery if persistent.

    Cryptorchidism

    • One or both testes fail to descend into the scrotum.
    • Complicated by sterility, inguinal hernia, and testicular torsion (requires emergency surgery).

    Impact of Genitourinary Surgery

    • Need anticipatory guidance.
    • Minimize negative impact on growth and development.
    • Home care (avoid prolonged tub baths, inspect dressings daily, restrict certain play activities, consider body image, sexual function, & perception)

    Check on Learning Questions

    • Include numerous questions covering various aspects of the genitourinary system's development, anomalies, diagnosis, and treatment.

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    Related Documents

    The Child With A Genitourinary Disorder PDF

    Description

    Explore the development of the urinary and reproductive systems, highlighting key milestones from gestation through puberty. Understand the importance of recognizing warning signs of potential sexual abuse and the assessments necessary for genitourinary function. Test your knowledge on these critical aspects of pediatric health.

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