involuntary discharge of urine

hold urine as long as possible, urinate in container, expected amount is child's age plus 2 (in ounces)

Family history of enuresis, associated bladder disorder, male, emotional event, behavioral disorders

Place alarmed moisture sensor on the bed to alert the child

pelvic floor exercises

decreases amount of urine

inhibits urination, monitor for suicidality, give with food, taper at 6-8 weeks

anticholinergic, reduced bladder contractions

febrile, systemic UTI

inflammation or infection of the bladder

inflammation of the urethra

inflammation of the renal pelvis and the kidney

stoppage of urine flow; urinary stagnation, a risk factor for UTI

abnormal backward or return flow of urine from the bladder into the ureters

takes 2-3 days, no such thing as stat, much be obtained in a sterile manor

escherichia coli

Urinalyses positive for protein, glucose, ketones, leukocytes, nitrites, RBCs, and/or acidic urine

radioisotope renography, Bladder wash outs, Ultrasonography, voiding cystourethrogram, IV pyelogram, dimercaptosuccinic acid scan

Finish the medication

wiping back to front, tight/nylon pants/underwear

Failure to clean under foreskin

6-12 months

between 3 and 6 years

Obstructive defect

Ventral (downward) curvature of the penis due to a fibrous band along the corpus spongiosum seen congenitally with hypospadias, or a downward curvature seen on erection in disease conditions causing a lack of distensibility in the tissues.

epispadias present

urethral opening on the underside (ventral) of the penis

congenital defect in which the urinary meatus is located on the upper (dorsal) surface of the penis

-wide urethra

stenosis of foreskin so that it cannot be retracted over the glans penis

failure of the testicles to descend into the scrotum

a fluid-filled sac in the scrotum along the spermatic cord leading from the testicles

enlarged, dilated veins near the testicle

twisting of the spermatic cord causing decreased blood flow to the testis

congenital malformations that prevent visual identification of child's sex. chromosome analysis to determine genetic karotype.

Poor self esteem, altered body image, social isolation, fear

benign inflammation of glomeruli lasts 1-2 weeks, causes intravascular coagulation. Often with oliguria, edema, HTN, and circulatory congestion, hematuria and proteinuria

diuretics, antihypertensives, antibiotics, phosphate binders, sodium polystyrene sulfate

alterations in the glomerular membrane allow proteins (esp albumin) to pass into the urine resulting in decreased blood osmotic pressure, which leads to proteinuria, hyperlipidemia, and edema (primary, secondary, or congenital)

occurs after or is associated with glomerular damage due to a known cause

Proteinuria up to 15 grams in 24 hour specimen, Hyaline casts, few RBCs, Oval flat bodies, Increased specific gravity

hypoalbuminemia, Hyper lipidemia, Hemoconcentration with elevated HGB, HCT, and platelets, possible hyponatremia, decreased calcium, increased erythrocyte sedimentation rate. Glomerular filtration rate normal to high.

Corticosteroids (prednisone), furosemide, plasma expanders (25% albumin), immunosuppressant: cyclophosphamide

acute kidney failure, hemolytic anemia, and thrombocytopenia. one of the main causes of acute kidney injury in early childhood. Breakdown of RBCs clog kidneys. Toxins enter the bloodstream and destroy RBCs often caused by an upper respiratory or GI infection

90% of HUS cases, caused by ingestion of shiga toxin producing E. coli

decreased H+H, elevated reticulocyte, BUN = Creat counts, urine positive for blood, protein, and casts, thrombocytopenia

inability of kidneys to excrete waste material, concentrate urine and conserve electrolytes

prerenal, intrinsic renal, and post-renal

dehydration, surgical shock, trauma, poisoning, prolonged anesthesia

damage to glomeruli, tubules, or kidney vasculature from disease or nephrotoxicity

occurs with urinary tract obstructions that affect the kidneys bilaterally

diseased kidneys can no longer maintain normal chemical structure of body fluids under normal condition and there is extensive irreversible damage to the nephrons

congenital, renal and urinary tract malformations a vesicoureteral reflux.

Glomerular and hereditary renal disease

hyperkalemia, hypocalcemia, hyperphosphatemia, anemia, elevated BUN+Creat, metabolic acidosis

phosphorus ,potassium, protein to RDA,