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Question Answer
By _______ months of age, kidney function is nearly like that of the adult.
Show Answer
6-12 months
What substances aren't reabsorbed as well in the kidneys in premature infants? (4)
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In premature infants, the reabsorption of glucose, sodium, bicarbonate, and phosphate is reduced
Why are the infant's kidneys not as effective in concetration urine as an older child's/adult's?
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The kidneys cannot concentrate urine as efficiently because only 20% of the nephrons don’t have long enough loops of Henle to reach the inner medulla, where concentration and reabsorption occur.
What physiological difference in young children (as opposed to adults) makes them more susceptible to urinary tract infections?
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Young children have shorter urethras, which can predispose them to urinary tract infection
At what age do most children have voluntary bladder control?
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Between ages 4-5
T/F Children with acute renal failure can regain kidney function.
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True
What is the normal urine specific gravity in the pediatric population?
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Specific gravity – normal 1.002 – 1.030
What is the normal pH of urine in the pediatric population?
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pH of urine – 4.6 – 8.0
What are the signs and symptoms of a urinary disorder in a neonate?
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Poor feeding, Vomiting, Failure to thrive, Rapid respiration (acidosis), Respiratory distress, Spontaneous pneumothorax, Frequent urination, Screaming on urination, Poor urinary stream, Jaundice, Seizures, Dehydration, Enlarged kidneys or bladder
What are the signs and symptoms of a urinary disorder or disease in infancy?
Show Answer
Poor feeding, Vomiting, Failure to thrive, Excessive thirst, but doesn’t want milk. Prefers glucose water, Frequent urination, Straining or screaming on urination, Foul smelling urine, Pallor, Fever, Persistent diaper rash, Seizures, Dehydration, Enlarged kidneys or bladder.
What are the signs and symptoms of a urinary disorder or disease in childhood?
Show Answer
Poor appetite, Vomiting, Growth failure, Excessive thirst, Enuresis, incontinence, frequent urination, painful urination, Swelling of face, Seizures, Pallor, Fatigue, Blood in urine, Abdominal or back pain, Edema, Hypertension, Tetany
Why is the use of a Fleet enema dangerous for children with chronic renal failure?
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Use of Fleet enema in children with chronic renal failure is potentially lethal because it can cause hyperphosphatemia.
How is the glomerular filtration rate different in infants and young toddlers when compared to an adult?
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It is slower
Why is an infant/young toddler at greater risk for dehydration than an adult?
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Their kidneys are less able to concentrate urine and reabsorb amino acids
The renal syste usually reaches functional maturity at around ______ years of age.
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2 years of age
Bladder capacity is about _____ mL in the newborn, making it not unusual if they void between 9-10 times a day.
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30 mL
The expected urine output of an infant/young toddler is ______mL/kg/hour.
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0.5-2 mL/kg/hr
What maternal history might be significant when assessing a child for a renal disorder/disease? (5)
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Polyhydramnios, oligohydramnios, diabetes, HTN, or alcohol/cocaine ingestion.
What neonatal history might be significant when assessing a child for a renal disorder/disease?
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Single umbilical artery, abdominal mass, chromosome abnormality, or congenital malformation
What medications are used to treat/prevent bladder spasms in the pediatric population?
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Anticholinergics like oxybutynin, propantheline, bromide, or a belladonna & opium suppository
Drugs like oxybutynin, propantheline, bromide, or a belladonna & opium suppository are used to treat what urinary symptom?
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Bladder spasms
What GU condition is desmopressin/DDAVP used to treat?
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Enuresis (it's an antidiuretic)
_______ can be administered via nasal spray to treat enuresis. It can cause nasal irritation, nausea, flushing or headache. It should be given at bedtime, alternating nares each night.
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DDAVP/desmopressin (diuretic)
What medication is used to stimulate production of gonadal steroids to precipitate testicular descent in a child with cryptorchidism?
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Human chorionic gonadotropin (hCG)
Corticosteroids are the class of medications that are used to treat what GU disorder?
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Nephrotic syndrome
Cyclophosphamide/Cytoxan and chlorambucil/Leukeran are cytotoxic drugs that are used to __________ in children with nephrotic syndrome.
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Used to induce prolonged remission in nephrotic syndrome
What is the most useful method for obtaining a sterile urine specimen from a neonate or young infant?
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Suprapubic aspiration: a needle is inserted into the bladder through the anterior wall of the abdomen and then the urine is aspirated
What conditions would cause an elevation in serum BUN levels?
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Dehydration, high protein diet
What conditions would cause a decreased serum BUN level?
Show Answer
Overhydration or malnutrition
Which is a more direct measurement of renal function, serum BUN or serum creatinine?
Show Answer
Serum creatinine, it is minimally affected by liver function


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