Week 9: Evaluation and Management of Renal and Genitourinary Disorders.
The care of genitourinary (GU) disorders can range from primary care diagnosis and treatment to referral for specialized care, making it essential for you to identify when a patient’s needs fall within your scope of practice. Consider Hannah, who received specialized treatment for a GU disorder. When Hannah was born, her bladder was misshapen and located outside of her body, requiring immediate surgery. Although the surgery was a success, she began to present with complications at age 2. As is common among children with her condition, bladder exstrophy, she suffered from frequent urinary tract infections (Miami Children’s Hospital, 2012). Although you might not treat bladder exstrophy as an advanced practice nurse, you must be able to treat resulting complications that present later in the patient’s life. In your role, you will care for pediatric patients with GU disorders, and like Hannah, some of these patients will have unique needs, requiring long-term treatment and management.
This week you explore genitourinary disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.
By the end of this week, students will:
*These Learning Objectives support assignments that are due this week but were assigned in Weeks 8 and 9.
Time Logs: You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier.
This chapter presents information related to the anatomy and physiology of the genitourinary system. It then explores assessment and management strategies for genitourinary disorders, including common genitourinary conditions in males.
This chapter explores female anatomy and physiology from gestation through puberty and adolescence. It also provides information related to anticipatory guidance, adolescent pregnancy prevention, contraceptive use, and assessment and management strategies for disorders.
American Academy of Pediatrics, Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. (2011). Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 128(3), 595–610. Retrieved from http://pediatrics.aappublications.org/content/128/3/595.full?sid=cc35023c-502d-474a-9856-bfb5e38eed54
Cox, A. M., Patel, H., & Gelister, J. (2012). Testicular torsion. British Journal of Hospital Medicine, 73(3), C34–C36.
Note: Retrieved from the Walden Library Databases.
This article explores the process of identifying, diagnosing, and treating patients presenting with testicular torsion. It describes the importance of patient history, performing an ultrasound, and timely surgical treatment.
Nicolle, L.E., Bradley, S., Colgan, R., Rice, J.C., Schaeffer, A., & Hooton, T.M. (2005). Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults. Clinical Infectious Diseases, 40(5), 643-654.
Discussion: Diagnosis and Management of Genitourinary Disorder
Assignment: Board Vitals
Many genitourinary (GU) disorders such as kidney disease begin developing during childhood and adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for pediatric patients, to identify potential signs and symptoms. Although some pediatric GU disorders require long-term treatment and management, other disorders such as bedwetting or urinary tract infections are more common and frequently require only minor interventions. In your role with pediatric patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following three case studies.
Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.
Case Study 3
HPI: Mark is a 15-year-old with complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago after a wrestling match. He describes the pain as a dull ache and has gradually worsened to where he can no longer stand without doubling over. He is afebrile and in marked pain.
PE: Physical exam is negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign.
By Day 3
Post an analysis of your assigned case by responding to the following:
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to colleagues who selected different case studies than you did.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!