This is a comprehensive and detailed note on nursing care of genitourinary and Reproductive disorders in children to r Nur 433.
*Essential Study Material!!
Nursing Care of Genitourinary and Reproductive Disorders in Children
____________________________________________________________________________
Enuresis
● Enuresis: is uncontrolled or unintentional urination that occurs after a child is beyond an
age at which bladder control is achieved
● Diagnosis:
○ Occurs at least 2x/week for at least 3 months
○ At least 5 years old
■ There is criteria to follow
○ Rule out ALL organic causes (UTI) prior to dx.
● Two Types:
○ Primary enuresis: A child has never been free of bed-wetting for any extended
periods of time.
○ Secondary enuresis: A child who started bed-wetting after development of urinary
control
○ Cause can be due to sexual abuse
● Expected findings:
○ History of:
■ Alterations in toilet training, voiding/bowel patterns
■ Chronic or acute illness (UTI, DM, sickle cell disease, neurologic deficits)
■ Family disruptions/emotional stressors
■ Family history of enuresis
■ Fluid intake, especially in the evening
○ Complications:
■ Low self-esteem, altered body image, social isolation, fears
■ Early interventions can alleviate long-term emotional issues
● Nursing Care:
○ Evaluate the child’s coping and available support systems.
○ Support the child and family, involve all in teaching
○ Assist them to understand the disorder
○ Allow the child to wear regular sleep wear and avoid diapers.
○ Use positive reinforcement (avoid punishing/scolding following an incident)
○ Assist the child in keeping a calendar of wet and dry days.
○ Have child assist with changing bed linens following accident
○ Make environmental changes (night light, bottom bunk)
○ Refer to appropriate resources (support groups, counseling)
● Intake modifications:
○ Encourage fluids during the day/restrict in evening
○ Avoid holding urine during the day
○ Avoid fruit and fruit drinks after 1600.
○ Avoid caffeinated or carbonated drinks after 1600
○ Avoid constipation: increase fiber in diet
○ Wake the child up during the night to void.
, ○ Administer prescribed medications.
● Medications:
○ Antidiuretic hormone (Desmopressin/DDAVP)
■ Reduces the volume of urine (monitor I&O)
■ Given at bedtime
■ Can be given orally or nasally
○ Tricyclic Antidepressants
■ Inhibits urination
■ Treatment 6-8 weeks
■ Given with food 1 hour before bedtime
■ Educate on adverse reactions (mood changes, suicidality)
■ Avoid sun exposure
○ Anticholinergics
■ Oxybutynin chloride reduces bladder contractions.
Urinary Tract Infections
● UTI: An infection in any portion of the urinary tract. Can be asymptomatic or symp.
○ Terms to know:
■ Bacteriuria: bacteria in the urine
■ Persistent UTI: unresolved bacteriuria with antibiotic therapy
■ Febrile UTI: symptomatic bacteriuria with fever
■ Cystitis: inflammation of the bladder
■ Urethritis: inflammation of the urethra
■ Pyelonephritis: inflammation of the upper urinary tract and the kidneys
■ Urosepsis: bacterial illness
● Risk Factors:
○ Urinary stasis
○ Urinary tract anomalies
○ Reflux within the urinary tract system
○ Constipation
○ Onset of toilet training
○ Uncircumcised males (inadequate hygiene)
○ Females (urethra in close proximity to rectum)
○ Synthetic, tight underwear and wet bathing suits
○ Sexual activity
● Clinical Findings:
○ INFANTS
■ Increase in irritability
■ Screaming or straining with urination
■ Poor feeding, vomiting, or failure to gain weight
■ Increase in thirst
■ Frequent urination
■ Foul-smelling urine
■ Fever
■ Diaper rash
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.09. You're not tied to anything after your purchase.
