s
Learning Guide
Nursing Care of the Pediatric Individual with
a Genitourinary Disorder
Chapter 44
Structural Defects in the Urinary System and related pathology
UTI:
1. What are treatment approaches for enuresis and related nursing care?
2. What is the most common cause of UTI in children?
3. Many children do not complain of the usual signs and symptoms of a urinary
tract infection. What are the differences between adult S&S and infant-child
S&S?
4. What teaching should the nurse include regarding prevention of UTI in
infants, children and adolescents?
a. _________
b. _________
c. _________
d. _________
e. _________
5. What are the common sites for obstruction?
6. What is the main problem with reflux of urine?
7. What are the clinical manifestations?
8. What are common diagnostic tests for urinary conditions?
Obstructive Uropathy/ Vesicoureteral reflux:
9. What is the treatment and nursing care for a client with obstructive
uropathy.
10. What is exstrophy of the bladder?
11. What are the main goals of treatment? What are the two main priorities of
pre-operative nursing care and how are they accomplished?
12. What is the post-operative nursing care of the infant following surgical
reconstruction for bladder exstrophy?
13. Compare hypospadius with epispadius.
a. Why would the nurse question an order to prepare an infant with
either of these conditions for circumcision?
b. What is the relation of these conditions to infertility?
14. What is the focus of post-operative care for this child? What is the related
nursing interventions?
15. Why does the surgery usually take place prior to 1 year of age?
Cryptorchidism:
16. What is cryptorchidism?
17. What important information should be included for post-op care and
discharge teaching?
Miscellaneous Disorders and Anomalies of the Genitourinary Tract
Acute Poststreptococcal Glomerulonephritis:
18. Define glomerulonephritis.
19. What is the most common causative organism for this pathology?
20. Gomerulonephritis is a common complication of what childhood infection?
21. What role do immune complexes play in the development of
glomerulonephritis?
22. What assessment findings does the nurse expect in a child with acute
glomerulonephritis?
a. Renal
b. Cardiovascular
c. Neuro
23. What diagnostic indicators must the nurse monitor?
a. Urinalysisb. Serum- (what are the normal values? Does the indicator increase
in value or decrease? Which is most indicative of the condition?)
 ASO titer
 ESR
 BUN
 Creatinine
24. What are nursing interventions related to care of the child with AGN?
25. Why are Hbg & Hct levels low in a child with glomerulonephritis?
Nephrotic Syndrome:
26. Explain the changes in vascular function of the kidney in a client with
nephrotic syndrome.
a. What laboratory findings must the nurse monitor specific to this
condition?
b. What fluid shift does hypoalbuminemia cause or What is
the physiologic basis for the edema present in children with
nephrotic syndrome?
c. Why is the rennin-angiotension system stimulated. What is
the results of this?
27. What are the clinical manifestations of nephrotic syndrome?
28. Differentiate between primary (MCNS-minimal change nephrotic syndrome)
and secondary nephrotic syndrome.
29. Prednisone is the primary drug used in treating nephritic syndrome. What
are the side effects and nursing implications?
30. Why are children with nephrotic syndrome susceptible to infection? What are
appropriate measures used to prevent infection?
31. When caring for a child with nephrotic syndrome what priority nursing
interventions should the nurse include related to:
a. Medications:
 Albumin
 Antibiotics
 Diuretics
 Corticosteroids
b. Diet
c. Activity
d. Laboratory findings
e. Client/ family teaching (remember the immediate and long-term
effects)
32. In client/ family teaching, how would the nurse explain remission for
nephrotic syndrome?