{"id":5351,"date":"2011-07-14T20:25:43","date_gmt":"2011-07-14T20:25:43","guid":{"rendered":"http:\/\/crashtext.org\/misc\/5351.htm\/"},"modified":"2011-10-02T19:55:15","modified_gmt":"2011-10-02T19:55:15","slug":"renal-genitourinary-tract-disorders","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/pediatrics\/renal-genitourinary-tract-disorders.htm\/","title":{"rendered":"Pediatric Renal and Genitourinary Tract Disorders"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>UTIs<\/h2>\n<p>Outpatient Treatment 5-7 day course of oral abx (amoxicillin, keflex, etc.)<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Hoberman A<\/strong>, Charron M, Hickey RW, <em>et al.<\/em> Imaging studies aftera first febrile urinary tract infection in young children. <em>NEngl J Med<\/em> 2003;<strong>348<\/strong>:195\u0096202.<\/p>\n<p>no benefit to imaging any child who has had a third trimester ultrasound<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Use 3-Man Technique for Catheter Urinalysis<\/strong><\/p>\n<p>Here&#8217;s an easier way to obtain a catheter urinalysis on pediatric females when you need a very clean urine specimen, such as for a septic work-up on a small child, or you need to rule out a urinary tract infection.<\/p>\n<p>&#8220;It&#8217;s a three-man procedure, but well worth the personnel because it&#8217;s quick and relatively nontraumatic,&#8221; says Teri Howick, RN, nurse educator for the ED at McKay Dee Hospital in Ogden, UT.<\/p>\n<p>The first person, who can be the parent or caregiver, if he or she is willing, stands at the head, reaches over the patient and holds the legs bent in a frog-leg position, she explains. &#8220;This is best accomplished by grasping the leg just below the knee, and flexing the leg so it is bent and slightly spread laterally,&#8221; says Howick.<\/p>\n<p>The second person stands below the patient, and with gloved hands, gently grasps each labia majora with a dry 2&#215;2, then slightly pulls them <em>out<\/em> \u0097 not to the side, she instructs.<\/p>\n<p>&#8220;Pulling to the side, which seems like the most logical thing to do, puts undo tension on the fragile tissue of the perineum and actually can tear it,&#8221; says Howick. &#8220;The labia should be pulled toward the foot of the bed. By this simple maneuver, you will be amazed at how the anatomy just falls into place, like opening a curtain.&#8221;<\/p>\n<p>The vaginal opening as well as the elusive urinary meatus are easily visualized in normal anatomy, says Howick. The third person does a quick cleaning, and with a small catheter, take care to aim toward the small of the back \u0097 downward and at a 45-degree angle or more, instead of straight in as you would an adult female, she explains. &#8220;I have had overwhelming success with this technique,&#8221; says Howick.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>|\u00a0\u00a0 \u00a0\u00a0 |\u00a0\u00a0 \u00a0\u00a0 |<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[11],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Pediatric Renal and Genitourinary Tract Disorders - 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