Renal System- Test Solution Manual Fully Solved Latest 2025 (Graded A+)
Hyponatremia (decreased sodium) - Answers Muscle weaknes, Headaches
Fatigue, confusion, vomiting, coma
Hypernatremia (increased sodium) - Answers Tachycardia, dry mucus membrane
decreased urinary output
Hypokalemia (decreased potassium) - Answers Anorexia, nausea, vomiting
abdominal distention
Hyperkalemia (increased potassium) - Answers Irritability, nausea and vomiting
diarrhea
Hypokalcemia (decreased calcium) - Answers osteoporosis, fractures, muscle spasms
tetany, n & v, vomiting.
Hypercalcemia (increased calcium) - Answers Renal calculi, coma, arrythmias, decreased reflex
BUN level - Answers 10-20 mg/dl
Creatinine level - Answers 0.5- 1.5 mg/dl
Calcium - Answers 9- 11 mg/ dl
Urine Specific Gravity - Answers 1.003- 1.030
POLYCYSTIC KIDNEY DISEASE - Answers - A cyst develops in the nephron (kidneys)
- It is an inherited disease of the kidneys.
-IN THE DOMINANT FORM- ONLY FEW NEPHRONS HAVE CYSTS.
-IN THE RECESSIVE FORM-100% OF NEPHRONS HAVE CYSTS FROM BIRTH.
- Cysts in kidneys would look like a cluster of grapes
- Patients would have hypertension. (Due to Renin Angiotensin System)
MANIFESTATIONS IN THE PATIENT:
-PAIN IS THE FIRST MANIFESTATION
-FLANK PAIN IS DULL, SHARP OR INTERMITTENT
,-DULL ACHING PAIN- is caused by increase kidney size, from infection from the cyst.
-SHARP INTERMITTENT PAIN- is when a cyst is rupture or when a stone is present.
-BERRY ANEURYSM
- can occur (bleeding into brain from ruptured intracranial vascular cysts)
- causes severe headaches, with or without vision changes (pay extra attention
to patients with severe headaches, since it can be a sign of a ruptured cyst).
DIAGNOSTIC TESTS:
- renal sonogrophy
- computed tomography
- MRI
INTERVENTIONS:
-BE VERY CAUTIOUS IN USING NSAIDS, BECAUSE IT CAN CAUSE BLEEDING
-ANTIHYPERTENSIVES AND DIURETIC AGENTS (ACE INHIBITOR, CALCIUM CHANNEL BLOCKER, BETA
BLOCKER)IS USED FOR HYPERTENSION.
Urinary Calculi/ Urilithiasis - Answers URINARY CALCULI is also called urilothiasis or KIDNEY STONES, and
it can results from anything from immobility, cancer, increased intake of Vitamin D, or an overactivity of
the Parathyroid gland.
Kidney stones is made up of:
calcium
magnesium
phosphorus
oxalate.
- High urine acidity or alkalinity contributes to stone formation.
SYMPTOMS (Urinary Calculi)
,Flank pain
fever
nausea and vomiting
changes in the urinary output.
*** There will be an increase in RBC's, WBC's and bacteria.
DIAGNOSTIC TESTS for urinary calculi would include x-ray, blood tests and a 24 hour urine test.
INTERVENTIONS:
Non Surgical Management:
- ↓ Incudes the use of laser to break the stone fragments
(Extracorporeal shock wave lithotripsy (ESWL).
patient is given a local anesthetic .
pt. is placed in a water bath or on a soft cushion.
shock waves are transmitted through the stones inside the kidney.
shock waves cause the calculi to break up into smaller pieces.
- ♦It is very important to strain the urine after the ESWL Procedure.
, * Encourage fluid intake after the procedure.
* Assess for any hemorrhage
Discharge Teaching (DIET) *Know for NCLEX:
If Uric Acid Stone:
Alkaline Ash & Low Purine Diet (limit wine, cheese & meat)
Give Allopurinol as prescribed
If Calcium Stone:
Calium Restricted Diet (Limit Dairy Foods)
Surgical Interventions:
- Uretherolithotomy
- Nephrolithotomy
Removal of renal calculi using a nephroscope.
Glomerulonephritis - Answers A NON BACTERIAL INFLAMMATION OF THE KIDNEY'S GLUMEROLUS.
Usually a result of an antigen antibody response to a beta hemolytic streptococci
(this means that the patient usually had strep throat 2-3 weeks prior).
SERUM CREATININE LEVEL
Hyponatremia (decreased sodium) - Answers Muscle weaknes, Headaches
Fatigue, confusion, vomiting, coma
Hypernatremia (increased sodium) - Answers Tachycardia, dry mucus membrane
decreased urinary output
Hypokalemia (decreased potassium) - Answers Anorexia, nausea, vomiting
abdominal distention
Hyperkalemia (increased potassium) - Answers Irritability, nausea and vomiting
diarrhea
Hypokalcemia (decreased calcium) - Answers osteoporosis, fractures, muscle spasms
tetany, n & v, vomiting.
Hypercalcemia (increased calcium) - Answers Renal calculi, coma, arrythmias, decreased reflex
BUN level - Answers 10-20 mg/dl
Creatinine level - Answers 0.5- 1.5 mg/dl
Calcium - Answers 9- 11 mg/ dl
Urine Specific Gravity - Answers 1.003- 1.030
POLYCYSTIC KIDNEY DISEASE - Answers - A cyst develops in the nephron (kidneys)
- It is an inherited disease of the kidneys.
-IN THE DOMINANT FORM- ONLY FEW NEPHRONS HAVE CYSTS.
-IN THE RECESSIVE FORM-100% OF NEPHRONS HAVE CYSTS FROM BIRTH.
- Cysts in kidneys would look like a cluster of grapes
- Patients would have hypertension. (Due to Renin Angiotensin System)
MANIFESTATIONS IN THE PATIENT:
-PAIN IS THE FIRST MANIFESTATION
-FLANK PAIN IS DULL, SHARP OR INTERMITTENT
,-DULL ACHING PAIN- is caused by increase kidney size, from infection from the cyst.
-SHARP INTERMITTENT PAIN- is when a cyst is rupture or when a stone is present.
-BERRY ANEURYSM
- can occur (bleeding into brain from ruptured intracranial vascular cysts)
- causes severe headaches, with or without vision changes (pay extra attention
to patients with severe headaches, since it can be a sign of a ruptured cyst).
DIAGNOSTIC TESTS:
- renal sonogrophy
- computed tomography
- MRI
INTERVENTIONS:
-BE VERY CAUTIOUS IN USING NSAIDS, BECAUSE IT CAN CAUSE BLEEDING
-ANTIHYPERTENSIVES AND DIURETIC AGENTS (ACE INHIBITOR, CALCIUM CHANNEL BLOCKER, BETA
BLOCKER)IS USED FOR HYPERTENSION.
Urinary Calculi/ Urilithiasis - Answers URINARY CALCULI is also called urilothiasis or KIDNEY STONES, and
it can results from anything from immobility, cancer, increased intake of Vitamin D, or an overactivity of
the Parathyroid gland.
Kidney stones is made up of:
calcium
magnesium
phosphorus
oxalate.
- High urine acidity or alkalinity contributes to stone formation.
SYMPTOMS (Urinary Calculi)
,Flank pain
fever
nausea and vomiting
changes in the urinary output.
*** There will be an increase in RBC's, WBC's and bacteria.
DIAGNOSTIC TESTS for urinary calculi would include x-ray, blood tests and a 24 hour urine test.
INTERVENTIONS:
Non Surgical Management:
- ↓ Incudes the use of laser to break the stone fragments
(Extracorporeal shock wave lithotripsy (ESWL).
patient is given a local anesthetic .
pt. is placed in a water bath or on a soft cushion.
shock waves are transmitted through the stones inside the kidney.
shock waves cause the calculi to break up into smaller pieces.
- ♦It is very important to strain the urine after the ESWL Procedure.
, * Encourage fluid intake after the procedure.
* Assess for any hemorrhage
Discharge Teaching (DIET) *Know for NCLEX:
If Uric Acid Stone:
Alkaline Ash & Low Purine Diet (limit wine, cheese & meat)
Give Allopurinol as prescribed
If Calcium Stone:
Calium Restricted Diet (Limit Dairy Foods)
Surgical Interventions:
- Uretherolithotomy
- Nephrolithotomy
Removal of renal calculi using a nephroscope.
Glomerulonephritis - Answers A NON BACTERIAL INFLAMMATION OF THE KIDNEY'S GLUMEROLUS.
Usually a result of an antigen antibody response to a beta hemolytic streptococci
(this means that the patient usually had strep throat 2-3 weeks prior).
SERUM CREATININE LEVEL
