MCN EXAM 4 2026 INTRAPARTUM FETAL
DISTRESS INTERVENTIONS ELECTRONIC
FETAL MONITORING AND LABOR CARE
NOTES
◉ Pediatric Renal Function****
Answer: • By 6 to 12 mo, kidney function approximates that of the
adult.
Ph of infant is adult is the same but when they are in acidosis state
they aren't able to excrete those hydrogen ions as much as an adult
*******
• In premature infants, the reabsorption of glucose, sodium,
bicarbonate, and phosphate is reduced
• First few weeks of life: kidneys cannot concentrate urine efficiently
because the loops of Henle are not yet long enough to reach the
inner medulla, where concentration and reabsorption occur. GFR
reaches full ability by 2 y/o
,• After the first few weeks of life, the ability of the kidneys to acidify
the urine reaches adult levels. With acidosis, however, there is only a
small increase in acid secretion, and susceptibility to acidemia rises
◉ Enuresis
Answer: • Repeated involuntary urination after 5 years of age
• Usually occurs while asleep (nocturnal enuresis)
• Primary Enuresis: child never achieved bladder control
• Secondary Enuresis: child achieved a period of bladder control,
and is now having episodes of wetting
◉ Causes of Primary enuresis ****
Answer: • Incomplete muscle maturation of the bladder
• Irritable bladder or decreased bladder capacity
• Anatomic abnormalities
• Neurologic alterations(i.e. neurogenic bladder,cerebral palsy) ****
,Primary often resolves spontaneously *****
◉ Secondary enuresis causes
Answer: • UTI ***
• Diabetes Insipidus
• Constipation
• Pinworm infections ***
• Stressors
• family disruption
• inappropriate pressure during toilet training
• inadequate attention to voiding cues
• sexual abuse
◉ How to assess for enuresis
Answer: • Review history of toilet training
• Check for UTI
• Tests:
• Urinalysis
• Urine culture
, • Blood studies
• Kidney Function
◉ Interventions of enuresis***
Answer: • Frequent toileting
• No fluids after 5pm
• ****Desmopressin: children older than 6 antidieuretic hormone ,
holds onto water volume so you don't pee at night
• ****Oxybutynin (Ditropan) -antispasmodic agent ** only for
children that are older than 5 years old
• Emotional support tochild/parents
◉ Urinary Tract Infection(UTI)
Answer: • Caused by bacteria from outside ascending the urethra
and into the bladder, and into the upper urinary tract
• 90% caused by fecal e. coli contamination
• In newborns, bacteria in the blood may seed the kidneys, and
produce a UTI
• Terminology
• UTI
DISTRESS INTERVENTIONS ELECTRONIC
FETAL MONITORING AND LABOR CARE
NOTES
◉ Pediatric Renal Function****
Answer: • By 6 to 12 mo, kidney function approximates that of the
adult.
Ph of infant is adult is the same but when they are in acidosis state
they aren't able to excrete those hydrogen ions as much as an adult
*******
• In premature infants, the reabsorption of glucose, sodium,
bicarbonate, and phosphate is reduced
• First few weeks of life: kidneys cannot concentrate urine efficiently
because the loops of Henle are not yet long enough to reach the
inner medulla, where concentration and reabsorption occur. GFR
reaches full ability by 2 y/o
,• After the first few weeks of life, the ability of the kidneys to acidify
the urine reaches adult levels. With acidosis, however, there is only a
small increase in acid secretion, and susceptibility to acidemia rises
◉ Enuresis
Answer: • Repeated involuntary urination after 5 years of age
• Usually occurs while asleep (nocturnal enuresis)
• Primary Enuresis: child never achieved bladder control
• Secondary Enuresis: child achieved a period of bladder control,
and is now having episodes of wetting
◉ Causes of Primary enuresis ****
Answer: • Incomplete muscle maturation of the bladder
• Irritable bladder or decreased bladder capacity
• Anatomic abnormalities
• Neurologic alterations(i.e. neurogenic bladder,cerebral palsy) ****
,Primary often resolves spontaneously *****
◉ Secondary enuresis causes
Answer: • UTI ***
• Diabetes Insipidus
• Constipation
• Pinworm infections ***
• Stressors
• family disruption
• inappropriate pressure during toilet training
• inadequate attention to voiding cues
• sexual abuse
◉ How to assess for enuresis
Answer: • Review history of toilet training
• Check for UTI
• Tests:
• Urinalysis
• Urine culture
, • Blood studies
• Kidney Function
◉ Interventions of enuresis***
Answer: • Frequent toileting
• No fluids after 5pm
• ****Desmopressin: children older than 6 antidieuretic hormone ,
holds onto water volume so you don't pee at night
• ****Oxybutynin (Ditropan) -antispasmodic agent ** only for
children that are older than 5 years old
• Emotional support tochild/parents
◉ Urinary Tract Infection(UTI)
Answer: • Caused by bacteria from outside ascending the urethra
and into the bladder, and into the upper urinary tract
• 90% caused by fecal e. coli contamination
• In newborns, bacteria in the blood may seed the kidneys, and
produce a UTI
• Terminology
• UTI
