Exam 2: Pedi/OB: Genitourinary

What is Acute Poststreptococcal Glomerulonephritis?

It is an acute or sudden inflammation of the glomeruli that can lead to acute renal failure.

What causes Acute Poststreptococcal Glomerulonephritis?

Happens 1–2 weeks after strep throat or skin infection

Immune complexes get trapped in kidneys → inflammation

What is the pathophysiology of Acute Poststreptococcal Glomerulonephritis?

Immune reaction → glomeruli inflamed

Blood leaks into urine → hematuria

Filtration slows → retains sodium + fluid

Causes swelling + high BP

What are the signs and symptoms of Acute Poststreptococcal Glomerulonephritis?

Hematuria (cola/tea-colored urine)

Edema (face, eyes, dependent areas)

Proteinuria (mild)

Hypertension

Oliguria (low urine), fatigue, ↓ GFR

What laboratory findings are seen in Acute Poststreptococcal Glomerulonephritis?

UA: blood, protein, RBCs, WBCs

↑ ASO titer (shows recent strep infection)

↑ BUN & creatinine

History of recent strep infection

What is the treatment for Acute Poststreptococcal Glomerulonephritis?

Antibiotics (for strep)

Antihypertensives (if BP > 140/90)

Diuretics (reduce fluid)

Daily weights + I&O

Hemodialysis if renal failure

Low sodium, low protein, low potassium diet

What is Nephrotic Syndrome?

A kidney disorder characterized by increased glomerular permeability to plasma proteins, which causes massive protein loss in urine, low blood albumin levels, severe pitting edema, and high cholesterol.

Whats the main idea of Nephrotic syndrome?

Leaky kidneys → losing protein → swelling everywhere

What causes Nephrotic Syndrome?

The exact cause is unknown but is thought to be an immune system response possibly triggered by infection.

What is the pathophysiology of Nephrotic Syndrome?

-Glomeruli leak protein → protein lost in urine

-Low albumin in blood → fluid leaves vessels → edema

-Low fluid in vessels (hypovolemia) → kidneys release renin + aldosterone → retain sodium + water → more swelling

-Liver makes more lipids/proteins → hyperlipidemia

-Lose immunoglobulins → infection risk

-Increased RBCs/platelets → blood clots (thrombosis)

What are the signs and symptoms of Nephrotic Syndrome?

-Edema + weight gain

-Swollen belly (ascites) or tight clothes

-Scrotal/labial edema

-Decreased urine output

-Dark, foamy urine (protein)

-Pale, tired

What tests diagnose Nephrotic Syndrome?

Urinalysis, serum protein and albumin levels, complete blood count, and chemistry panel.

What is the treatment for Nephrotic Syndrome?

-Corticosteroids (first-line)

-Diuretics (to reduce fluid)

-IV albumin

-Low sodium & fluid restriction

-Low cholesterol diet

What nursing care is important for Nephrotic Syndrome?

-Monitor fluid balance, weight, urine output

-Prevent infection + blood clots

-Encourage rest + activity as tolerated

-Teach low-sodium, low-fat diet

What is a Urinary Tract Infection?

An infection of one or more parts of the urinary tract.

What causes a Urinary Tract Infection in children?

Escherichia coli causes about eighty percent of cases. Risk factors include shorter urethra in females, uncircumcised males, urinary stasis, structural defects, and poor hygiene.

What are the signs and symptoms of a Urinary Tract Infection in infants?

Fever, poor feeding, vomiting, dehydration, persistent diaper rash, foul-smelling urine, and crying during urination.

What are the signs and symptoms of a Urinary Tract Infection in older children?

Frequent urination, painful urination, abdominal or back pain, bedwetting, blood in urine, and fever or chills.

What is the diagnostic test for a Urinary Tract Infection?

Urinalysis.

What is the treatment for a Urinary Tract Infection?

Complete the full course of prescribed antibiotics.

What education helps prevent Urinary Tract Infections?

Increase water intake

Maintain good hygiene

Avoid holding urine for long periods

Encourage frequent urination.

What is Enuresis?

Involuntary urination after the age when bladder control is expected, usually after five years old.

What is the difference between primary and secondary Enuresis?

Primary Enuresis means the child has never been dry for an extended time.

Secondary Enuresis starts after the child has been dry for a period.

What can cause Enuresis?

Physical:

-urinary tract infection

- diabetes mellitus

-kidney problems must be ruled out first.

Psychological:

-new siblings, death, moving, divorce, or school stress may also contribute.

What is Nocturnal Enuresis?

Bedwetting that happens during sleep.

When is Enuresis diagnosed?

at least twice per week for three months and is not due to a medical condition.

What are the symptoms of Enuresis?

Dribbling, urgency, infrequent urination, and sometimes painful urination.

What is the treatment for Enuresis?

Identify and treat the cause

Use medication if needed

Practice bladder training

Positive reinforcement

Limit fluids after dinner

Avoid caffeine and sugary drinks after 4 p.m.

Wake the child at night to urinate

Use bedwetting alarms.

What nursing care is important for Enuresis?

Support the child's self-esteem, avoid punishment or embarrassment, and focus on positive reinforcement.

How does an infant's urinary system differ from an older child's?

Infant kidneys cannot concentrate urine well, so they are less efficient

How are infants urethras compared to adults?

they are shorter

When should a baby have full kidney function?

12 months