FINAL EXAM STUDY GUIDE
Concepts Of Nursing:
The Childbearing/Child Caring Family
Galen College of Nursing
,Exam 4 Peds
Genitourinary Dysfunction
Can babies have UTIs?
- Yes, they can have febrile UTI during 1st 2 years.
- The ones who have the highest chance of UTIs is infant males that are older then 3 months of
age and are uncircumcised.
Differences between a Upper and Lower tract infection:
- Upper
o Involves renal parenchyma, pelvis and ureters
o Pyelonephritis
o Vesico-ureteral reflux
o Glomerulonephritis
- Lower
o Usually no systemic sx
o Cystitis *Inflammation of the bladder*
o Urethritis *inflammation of urethra*
Differences between uncomplicated and complicated infections:
- Uncomplicated: This happens in a otherwise normal urinary tract.
- Complicated: Structural defects
o Stones
o Obstruction
o Catheters
o Diabetes or neurologic disease
o Recurrent infections
Different types of UTI’s
- Recurrent
o Repeated episodes, reinfection in the person who prior infection was successful
eradicated. It occurs because original infection not adequately eradicated.
- Persistent: Bacteriuria despite antibodies
o Resistance developed or foreign body in urinary system serves as harbor and anchor for
bacteria to survive despite therapy.
Follow up cultures is important
o Unresolved bacteriuria: Bacteria resistant or drug discontinued before bacteriuria is
completely eradicated.
- Febrile:
, o Typically indicates pyelonephritis
- Urosepsis
o Bacterial illness; urinary pathogens in blood
How do we protect the urinary tract by maintaining sterility?
- Emptying bladder:
o Vesico-Ureteral junction competence:
Bladder ureter coming into this, there is a valve there. If this isn’t working
correctly the person can’t fully empty, the bladder. Emptying their bladder
depends on this.
o Peristaltic activity
- Normal antibacterial properties of urine and tract
o Acidic urine
o Increase fluid intake > more frequent flushing of kidney and bladder.
- Bacterial presence/Cause UTI’s
o From intercourse – movement of bacteria from perineum into the vagina
o Instruments used in procedures – allows bacteria present in opening of urethra to enter
urethra or bladder.
What are some pathogens that can cause UTI’s?
- Escherichia coli:
o This is the most common pathogen
- Streptococci
- Staphylococcus saprophyticus
- Occasionally fungal & parasitic pathogens
o This is generally
- Pseudomonas – nosocomial
UTI Etiology/Pathophysiology:
- Less common routes
o Bloodstream which is rare
For it to spread through the blood stream must have previous injury. Kidney
infection > prior injury to urinary tract.
Obstruction of ureter
Damage from stones
Renal scars
o Lymphatic system
What is Potter Syndrome?
- This is where the kidneys fail as the unborn baby is growing in the womb. Happens because of
the lack of ammonitic fluid.
, What is Polycystic Kidney?
- Kidney disorder passed down through families. It causes cysts on the kidney causing it to be
enlarged.
- It can happen anytime, infancy, childhood, or adulthood
- Can also develop with Potter syndrome or separately.
What can happen with the valve that empties the bladder in kids?
- Reflux in the ureter can cause problems, a lot of kids are born with them having issues with this
valve.
- Emptying the bladder is to protect/help but when you have issues with this they can’t empty the
bladder completely.
What are Clinical signs of UTI’s/cystitis/urethritis?
- Dysuria
- Frequent urination, more then every 2 hours
- Urgency
- Suprapubic discomfort or pressure