Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment
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. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment.
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Case Study 1

You see a 3-year-old with a 2-day history of complaints of dysuria with frequent episodes of enuresis despite potty training about 7 months ago. She is afebrile and denies vomiting. Physical examination is normal. Dipstick voided urine analysis reveals: specific gravity 1.015, Protein 1+ non-hemolyzed blood, 1+ nitrites, 1+ leukocytes, and glucose-negative. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment .

Case Study 2

Mark is a 15-year-old with complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago 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. Physical exam is negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment .

Case Study 3

Maya is a 5-year-old who presents for a well-child visit. She is a healthy child with no complaints. Physical examination is normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood, leukocytes, and nitrites. Her blood pressure is normal, and she is at the 60th percentile for height and weight.
To prepare:

• Review “Genitourinary Disorders” in the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment .
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment .

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Diagnosis and Management of Genitourinary Disorders Discussion Essay Assignment.

Heparin Induced Thrombocytopenia Essay
When an individual has a platelet count less than 150,000 platelets/uL, he or she is considered to have thrombocytopenia. This condition can occur because of genetic predispositions or can be acquired. When thrombocytopenia is seen due to congenital origin, the underlying disease could be TAR syndrome, Wiskott Aldrich syndrome, or a gene mutation. Acquired thrombocytopenia is usually seen in relation to viral infections, mediation use, a nutrient deficiency, , renal failure, or radiation therapy, or cancer (Huether & McCance, 2017, p. 541). Heparin Induced Thrombocytopenia Essay.
Thrombocyopenia can be induced with the use of heparin. Furthermore, this condition is called heparin induced thrombocytopenia (HIT) syndrome. It occurs in result to an immune response to the use of heparin. It is less common when using unfractionated heparin, like Lovenox. The immune response causes IgG antibodies to react against the heparin-platelet factor, which leads to platelet activation. The increase in platelet factor 4 and thrombin production leads to an increase in platelet consumption. Platelet consumption results in low platelet counts which appear five to ten days later after heparin was administered (Huether & McCance, 2017, p. 541).
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With HIT syndrome, the patient will experience venous and arterial clotting, while having low platelets levels. This problem is difficult to manage because the patient is clotting and has a risk for bleeding at the same time. Priority management of the patient’s condition is essential (Krzych, Nowacka, & Knapik, 2015).  Heparin Induced Thrombocytopenia Essay.
Drug Therapy
After HIT syndrome has been identified, it is important to stop the use of heparin and look at other avenues of anticoagulant therapy. There is not a reversal medication to stop HIT from occurring. Managing the patient based on their clinical manifestations is the mainstay of treatment (Huether & McCance, 2017, p. 541). Heparin Induced Thrombocytopenia Essay.
Behavior
Patients with HIT syndrome typically need platelet replacement. Platelets are a blood component and require consent from the patient prior to them being given. Some individuals have religious beliefs, such as a Jehovah witness, in regards to receiving blood products and will refuse platelet therapy. This therapy is patient choice, but refusal of platelets can be detrimental to the patient. It is important to give all patients the option to receive therapy and discuss pros and cons of their decision. Promoting patient decision making is essential as we strive to maintain their autonomy (Edelen, 2014). Heparin Induced Thrombocytopenia Essay.
References
Edelen, A. (2014). Blood products and the Jehovah’s witness: An ethical concern. Kentucky
Nurse, 62(2), 4-5.
Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis,
MO: Mosby. Heparin Induced Thrombocytopenia Essay.
Krzych, Ł. J., Nowacka, E., & Knapik, P. (2015). Heparin-induced thrombocytopenia.
Anaesthesiology Intensive Therapy, 47(1), 63-76. doi:10.5603/AIT.2015.0006. Heparin Induced Thrombocytopenia Essay