Pediatric Nursing Demystified

Blood in urine

Hypertension

Vomiting

Constipation

Anemia

Test Results

Ultrasound: Identifies the size of the mass and if the mass is solid

CT scan: Identifies the location of the mass

Magnetic resonance imaging (MRI): Identifies the location of the mass

Chest radiograph: Identifies the location of the mass

Urograph: Assesses kidney function

Treatment

Biopsy to determine the type of tumor

Surgical removal of the tumor and the kidney if necessary

Chemotherapy (dactinomycin [Cosmegen], vincristine) to reduce the

size of the tumor

Radiation to reduce the size of the tumor

Nursing Intervention

Handle the child carefully during transportation and repositioning to

avoid rupturing the tumor capsule.

Explain the disorder and treatment to the family.

Nursing alertDon’t palpate the site of the tumor. Palpation can rupture the

tumor capsule resulting in the tumor metastasizing quickly.

Pyelonephritis

What Went Wrong?

Pyelonephritis is a kidney infection typically following a urinary tract

infection commonly caused by E. coli, Klebsiella, Enterobacter, Proteus,

Pseudomonas,andStaphylococcus saprophyticus.Inflammation may impair

renal function.

Signs and Symptoms

Flank pain

Fever due to infection

Chills

Frequency, urgency, dysuria due to urinary tract infection

Nausea, vomiting, and diarrhea due to infection

Increased heart rate due to fever

Costovertebral angle (CVA) tenderness

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CHAPTER 12/ Genitourinary Conditions^269