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Professional Clin Nursing IV (NURS 4279) Peds Genitourinary Dysfunction

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John Marsh
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Columbus State University

Professional Clin Nursing Iv (NURS 4279)

Peds genitourinary dysfunction

● Urinary tract infection (UTI)
○ Presence of pathogen in the urinary tract
■ Pyuria + Bacteria in an appropriately collected specimen
○ One of the most common conditions of childhood; 10% of children have a febrile
UTI in the first 2 years of life
○ Most important host factor is urinary stasis
■ Can result from reflux, anatomic abnormalities, neurogenic bladder,
voiding dysfunction, constipation
○ Caucasians, females, and uncircumcised males are at higher risk
■ Greatest risk= females < 12 months and uncircumcised males < 3 months
● Classification of UTI
○ Lower tract infection -> Could be asymptomatic/afebrile or pain, frequency,
urgency
■ Cystitis/Urethritis
○ Upper tract infection -> Fever, back/flank pain. Concern for renal scarring and
decreased kidney function
■ Pyelonephritis
● Etiology and pathophysiology of UTIs
○ Organisms that commonly cause UTIs
■ Escherichia coli (gram neg) is the most common pathogen (80% of
cases)
■ Strep, Staph and others possible
○ Anatomic or physical causes
■ Short urethra in girls (shorter distance)
■ Uncircumcised males
● Etiology and pathophysiology of UTIs
○ Physiologic and mechanical defense mechanisms that maintain sterility
■ Emptying the bladder
■ Normal antibacterial properties of the urine and tract
■ Slightly acidic (pH 6) environment of urine -> bacteria prefer an alkaline
environment
○ Alteration of defense mechanisms increases the risk of UTIs -> biggest is urinary
stasis
○ Organisms are usually introduced via an ascending route from the urethra
○ Contributing factor is urologic instrumentation
■ Allows bacteria present in the opening of the urethra to enter the urethra
or bladder
○ Sexual intercourse promotes bacteria from the perineum and vagina to enter
urethra
■ May cause minor urethral trauma

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Professional Clin Nursing IV (NURS 4279) Peds Genitourinary Dysfunction

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