DISEASES OF THE URINARY ORGANS

Problem No. 62

You are a nurse in the Pediatric Nephrology Department. A 14-year-old girl was admitted to the hospital with a diagnosis of acute glomerulonephritis.

During a nursing examination, the nurse received the following data: complaints of general weakness, poor appetite, periodic headaches, and sometimes swelling began to appear on her face and legs, which the girl associated with a large amount of liquid she had drunk.

History: frequent SARS, tonsillitis, dental caries. During the dispensary examination in the general analysis of urine revealed a slight proteinuria and erythrocyturia. And the girl was sent for a hospital examination.

Objectively: the skin is pale, clean, the face and legs are pasty. Pulse – 104 per minute, blood pressure – 130/80 mm. rt. Art., NPV – 20 per minute. Abdomen of the correct form, soft, painless. Physiological functions are normal.

Tasks

  1. What examination should the patient undergo?
  2. Find out what needs are being met.
  3. Formulate the patient’s problems
  4. Define goals and create a nursing intervention plan with motivation.

Problem No. 63

You work as a ward nurse at a children’s hospital. A 6-year-old girl is hospitalized with a diagnosis of Acute pyelonephritis.

During the nursing examination, the following data were obtained: general weakness, loss of appetite, body temperature 38.6 degrees C. The girl is lethargic, capricious. Complains of weakness, headache, abdominal pain and painful urination. The skin is pale, clean. Tongue dry, covered with white coating. The abdomen is soft. Positive symptom of Pasternatsky on the left. Respiratory rate 26 per minute, BP 100/60 mm Hg, pulse 102 per minute. Urine cloudy, urination frequent, painful.

From the anamnesis: sick for two days. The disease began with fever with chills, frequent and painful urination. On the eve of the disease, she fell from a tree, hitting her lumbar region. The local doctor sent to the hospital.

Tasks

  1. What changes are typical in urinalysis in this pathology?
  2. Find out what needs are being met.
  3. State the patient’s concerns.
  4. Define goals and create a nursing intervention plan with motivation.

Problem No. 64

You are a ward nurse at a children’s hospital. A 5-year-old girl with a diagnosis of Acute pyelonephritis was admitted to your post.

Nursing examination obtained the following data: sick on the 2nd day, the disease began after hypothermia. In the evening the temperature rose to 38.3 degrees C, there were pains in the left lumbar region, frequent (up to 8-10 times a day) and painful urination. The local doctor sent for hospitalization.

On examination, he complains of weakness, abdominal pain, nausea, chills, and asks to go home. The temperature is 38.4 degrees C. The skin is pale, periorbital cyanosis is pronounced. The mucous membrane of the pharynx and nose without acute inflammatory changes. The tongue is slightly coated with white. On palpation of the abdomen, pain is noted to the left of the navel, in the left iliac region and above the womb. A positive symptom of Pasternatsky is revealed on the left. Urinate profusely and often. Urine on examination is yellow, slightly hazy.

The girl is scheduled for research:

– general urine analysis.

– urinalysis according to Nechiporenko

– Urinalysis according to Zimnitsky.

– Ultrasound of the abdominal organs

– intravenous excretory urography.

Tasks

  1. What is the purpose of this study for the patient?
  2. Find out what needs are being met.
  3. State the child’s problems.
  4. Make a nursing intervention plan with motivation.

Problem No. 65

You are a ward nurse at a children’s hospital. A 5-year-old girl was admitted with her mother for inpatient treatment with a diagnosis of acute glomerulonephritis.

During the nursing examination, the nurse received the following data: Two weeks ago, the girl had severe follicular tonsillitis. Then the mother noticed that the girl had swelling on her face and legs, she was frightened, drawing attention to the changed color of her urine. Immediately sought medical attention and was sent to the hospital.

On examination: the consciousness is clear, the girl is active, easily comes into contact, her appetite, according to her mother, is reduced. Complains of a headache. The skin is pale, the nutrition is good. Eyelids swollen. Temperature 38 degrees C. Respiratory rate 20 per minute, pulse 120 beats. in min. satisfactory qualities, blood pressure – 130/80 mm Hg. The abdomen is of the correct form, participates in the act of breathing, painless. Urination is rare, not abundant, painless, urine is cloudy, the color of “meat slops”,

Exercise

  1. What changes in urinalysis do you expect in this patient?
  2. Find out what needs are being met.
  3. Identify the patient’s problems.
  4. Set goals and create a nursing intervention plan with motivation.

Problem No. 66

You are a nurse in a children’s hospital. An 11-year-old child with a diagnosis of “Acute glomerulonephritis with nephrotic syndrome” was admitted to your post.

During the nursing examination, the following data were obtained: The child is lethargic, capricious, reluctant to make contact. Appetite is reduced. Body temperature 37, 4 degrees C. Pale skin. The face is puffy, edemas are expressed on the torso and extremities. Pulse – 116 per minute, NPV – 24 per minute, BP-105/70 mm Hg. Urinating rarely, in small portions. Complains of back pain. In the analysis of urine: protein – 3.3%, density – 1012, leuk. – 2-3 in p / sp., er.-5-6 in p / p., cylinders – 5-6 in p / sp.

Tasks

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