C HAPTER 24: A LTERATIONS IN
G ENITOURINARY F UNCTION
1. Identification and treatment of cryptorchid testes should be done by age 2 years.
What is an important consideration?
a. Medical therapy is not effective after this age.
b. Treatment is necessary to maintain the ability to be fertile when older.
c. The younger child can tolerate the extensive surgery needed.
d. Sexual reassignment may be necessary if treatment is not successful.
ANS: B
The longer the testis is exposed to higher body heat, the greater the likelihood
of damage. To preserve fertility, surgery should be done at an early age.
Surgical intervention is the treatment of choice. Simple orchiopexy is usually
performed as an outpatient procedure. The surgical procedure restores the
testes to the scrotum. This helps the boy to have both testes in the scrotum by
school age. Sexual reassignment is not indicated when the testes are not
descended.
2. Congenital defects of the genitourinary tract, such as hypospadias, are usually
repaired as early as possible to accomplish what?
a. Minimize separation anxiety.
b. Prevent urinary complications.
c. Increase acceptance of hospitalization.
d. Promote development of normal body image.
ANS: D
, Promoting development of normal body image is extremely important.
Surgery involving sexual organs can be upsetting to children, especially
preschoolers, who fear mutilation and castration. Proper preprocedure
preparation can facilitate coping with these issues. Preventing urinary
complications is important for defects that affect function, but for all external
defects, repair should be done as soon as possible.
3. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at
birth ask when they can begin toilet training their son. The nurse replies based on
what knowledge?
a. Most boys in the United States can be toilet trained at age 3 years.
b. Training can begin when he has sufficient bladder capacity.
c. Additional surgery may be necessary to achieve continence.
d. They should begin now because he will require additional time.
ANS: C
After repair of the bladder exstrophy, the childs bladder is allowed to increase
capacity. Several surgical procedures may be necessary to create a urethral
sphincter mechanism to aid in urination and ejaculation. With the lack of a
urinary sphincter, toilet training is unlikely. The child cannot hold the urine
in the bladder. Bladder capacity is one component of continence. A functional
sphincter is also needed.
4. An infant has been diagnosed with bladder obstruction. What do symptoms of
this disorder include?
a. Renal colic
b. Strong urinary stream
c. Urinary tract infections
, d. Posturination dribbling
ANS: D
Symptoms of bladder obstruction include poor force of urinary stream,
intermittency of voided stream, feelings of incomplete bladder emptying, and
posturination dribbling. They may also include urinary frequency, nocturia,
nocturnal enuresis, and urgency. Renal colic is a symptom of upper urinary
tract obstruction. Children with bladder obstruction have a weak urinary
stream. Urinary tract infections are not associated with bladder obstruction.
5. The parents of a child born with ambiguous genitalia tell the nurse that family
and friends are asking what caused the baby to be this w ay. Tests are being done
to assist in gender assignment. What should the nurses intervention include?
a. Explain the disorder so they can explain it to others.
b. Help parents understand that this is a minor problem.
c. Suggest that parents avoid family and friends until the gender is assigned.
d. Encourage parents not to worry while the tests are being done.
ANS: A
Explaining the disorder to parents so they can explain it to others is the most
therapeutic approach while the parents await the gender assignment of th eir
child. Ambiguous genitalia is a serious issue for the family. Careful testing
and evaluation are necessary to aid in gender assignment to avoid lifelong
problems for the child. Suggesting that parents avoid family and friends until
the gender is assigned is impractical and would isolate the family from their
support system while awaiting test results. The parents will be concerned.
Telling them not to worry without giving them specific alternative actions
would not be effective.
G ENITOURINARY F UNCTION
1. Identification and treatment of cryptorchid testes should be done by age 2 years.
What is an important consideration?
a. Medical therapy is not effective after this age.
b. Treatment is necessary to maintain the ability to be fertile when older.
c. The younger child can tolerate the extensive surgery needed.
d. Sexual reassignment may be necessary if treatment is not successful.
ANS: B
The longer the testis is exposed to higher body heat, the greater the likelihood
of damage. To preserve fertility, surgery should be done at an early age.
Surgical intervention is the treatment of choice. Simple orchiopexy is usually
performed as an outpatient procedure. The surgical procedure restores the
testes to the scrotum. This helps the boy to have both testes in the scrotum by
school age. Sexual reassignment is not indicated when the testes are not
descended.
2. Congenital defects of the genitourinary tract, such as hypospadias, are usually
repaired as early as possible to accomplish what?
a. Minimize separation anxiety.
b. Prevent urinary complications.
c. Increase acceptance of hospitalization.
d. Promote development of normal body image.
ANS: D
, Promoting development of normal body image is extremely important.
Surgery involving sexual organs can be upsetting to children, especially
preschoolers, who fear mutilation and castration. Proper preprocedure
preparation can facilitate coping with these issues. Preventing urinary
complications is important for defects that affect function, but for all external
defects, repair should be done as soon as possible.
3. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at
birth ask when they can begin toilet training their son. The nurse replies based on
what knowledge?
a. Most boys in the United States can be toilet trained at age 3 years.
b. Training can begin when he has sufficient bladder capacity.
c. Additional surgery may be necessary to achieve continence.
d. They should begin now because he will require additional time.
ANS: C
After repair of the bladder exstrophy, the childs bladder is allowed to increase
capacity. Several surgical procedures may be necessary to create a urethral
sphincter mechanism to aid in urination and ejaculation. With the lack of a
urinary sphincter, toilet training is unlikely. The child cannot hold the urine
in the bladder. Bladder capacity is one component of continence. A functional
sphincter is also needed.
4. An infant has been diagnosed with bladder obstruction. What do symptoms of
this disorder include?
a. Renal colic
b. Strong urinary stream
c. Urinary tract infections
, d. Posturination dribbling
ANS: D
Symptoms of bladder obstruction include poor force of urinary stream,
intermittency of voided stream, feelings of incomplete bladder emptying, and
posturination dribbling. They may also include urinary frequency, nocturia,
nocturnal enuresis, and urgency. Renal colic is a symptom of upper urinary
tract obstruction. Children with bladder obstruction have a weak urinary
stream. Urinary tract infections are not associated with bladder obstruction.
5. The parents of a child born with ambiguous genitalia tell the nurse that family
and friends are asking what caused the baby to be this w ay. Tests are being done
to assist in gender assignment. What should the nurses intervention include?
a. Explain the disorder so they can explain it to others.
b. Help parents understand that this is a minor problem.
c. Suggest that parents avoid family and friends until the gender is assigned.
d. Encourage parents not to worry while the tests are being done.
ANS: A
Explaining the disorder to parents so they can explain it to others is the most
therapeutic approach while the parents await the gender assignment of th eir
child. Ambiguous genitalia is a serious issue for the family. Careful testing
and evaluation are necessary to aid in gender assignment to avoid lifelong
problems for the child. Suggesting that parents avoid family and friends until
the gender is assigned is impractical and would isolate the family from their
support system while awaiting test results. The parents will be concerned.
Telling them not to worry without giving them specific alternative actions
would not be effective.
