NCLEX Deck

GU / Renal

NCLEX Clinical Study Booklet · 11 cards

Contents

Urinary Tract Infection.

Infection
What is Urinary Tract Infection?
  • Infection of the urinary tract (usually the bladder = cystitis).
  • More common in women (short urethra).
What are the Causes / Risk Factors?
  • E. coli (most common)
  • Catheterization
  • Poor hygiene
  • Urinary retention, sexual activity
What are the Symptoms?
  • Dysuria (burning)
  • Frequency, urgency
  • Cloudy, foul-smelling urine
  • Suprapubic pain
  • Hematuria
  • Elderly: confusion may be the only sign
How is it Diagnosed?
  • Urinalysis (↑WBC, bacteria, nitrites)
  • Urine culture
What is the Treatment?
  • Antibiotics
  • ↑fluids (2–3 L/day)
  • Void frequently; wipe front to back
  • Complete antibiotics; avoid irritants
NCLEX TipIn older adults, new confusion may be the only sign of a UTI. Teach wiping front-to-back and completing antibiotics.
© NCLEX Deck1 / 11

Pyelonephritis.

Infection
What is Pyelonephritis?
  • Infection of the kidney(s) — an upper UTI.
  • Can cause scarring or sepsis.
What are the Causes / Risk Factors?
  • Ascending UTI
  • Obstruction, reflux
  • Catheter, stones
What are the Symptoms?
  • Flank / CVA tenderness
  • High fever, chills
  • N/V
  • Dysuria, frequency
  • Cloudy / bloody urine
How is it Diagnosed?
  • Urinalysis & culture
  • ↑WBC
  • CT / ultrasound
What is the Treatment?
  • Antibiotics (may be IV)
  • ↑fluids
  • Antipyretics, pain control
  • Follow-up cultures; treat obstruction
NCLEX TipFlank pain + CVA tenderness + fever points to pyelonephritis (kidney), not just a bladder UTI.
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Acute Kidney Injury.

Emergency
What is Acute Kidney Injury?
  • Sudden decline in kidney function.
  • Prerenal, intrarenal, or postrenal — often reversible.
What are the Causes / Risk Factors?
  • Prerenal: hypovolemia, shock, HF
  • Intrarenal: nephrotoxins, ATN
  • Postrenal: obstruction (stones, BPH)
What are the Symptoms?
  • ↓urine output (oliguria)
  • ↑BUN / creatinine
  • Fluid overload, edema
  • Hyperkalemia
  • Metabolic acidosis
  • Confusion
How is it Diagnosed?
  • ↑BUN/creatinine
  • Electrolytes (↑K)
  • Urinalysis
  • Renal ultrasound
What is the Treatment?
  • Treat cause; restore perfusion
  • Fluid & electrolyte management
  • Monitor I&O, daily weight
  • Dialysis if severe; avoid nephrotoxins
NCLEX TipWatch for hyperkalemia in AKI — it can cause fatal dysrhythmias. Monitor I&O, daily weight, and potassium.
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Chronic Kidney Disease.

Chronic
What is Chronic Kidney Disease?
  • Progressive, irreversible loss of kidney function.
  • End stage = dialysis or transplant.
What are the Causes / Risk Factors?
  • Diabetes (leading cause)
  • Hypertension
  • Glomerulonephritis
  • Polycystic kidney disease
What are the Symptoms?
  • ↑BUN/creatinine, ↓GFR
  • Fluid overload, edema, HTN
  • Hyperkalemia, metabolic acidosis
  • Anemia (↓erythropoietin)
  • Uremia (pruritus, nausea), bone disease
How is it Diagnosed?
  • ↓GFR
  • ↑BUN/creatinine
  • Electrolytes, CBC, imaging
What is the Treatment?
  • Restrict protein, sodium, potassium, phosphorus, fluids
  • Phosphate binders, erythropoietin
  • Manage BP & glucose
  • Dialysis / transplant
NCLEX TipCKD diet: limit protein, sodium, potassium, phosphorus, and fluids. Treat anemia with erythropoietin.
© NCLEX Deck4 / 11

Nephrotic Syndrome.

Renal
What is Nephrotic Syndrome?
  • Glomerular damage → massive protein loss in urine.
  • Hallmarks: proteinuria, hypoalbuminemia, edema, hyperlipidemia.
What are the Causes / Risk Factors?
  • Glomerular disease
  • Diabetes
  • Lupus
  • Infections, drugs
What are the Symptoms?
  • Massive proteinuria (frothy urine)
  • Generalized edema (periorbital, ascites)
  • Hypoalbuminemia
  • Hyperlipidemia
  • Weight gain
How is it Diagnosed?
  • Urinalysis (heavy protein)
  • ↓serum albumin
  • ↑lipids
  • Renal biopsy
What is the Treatment?
  • Corticosteroids, immunosuppressants
  • ACE inhibitors (reduce proteinuria)
  • Diuretics, low-sodium diet
  • Monitor edema, weight, infection risk
NCLEX TipNephrotic syndrome = massive proteinuria + edema + low albumin + high lipids. Watch for infection (loss of immunoglobulins).
© NCLEX Deck5 / 11

Glomerulonephritis.

Renal
What is Glomerulonephritis?
  • Inflammation of the glomeruli.
  • Often post-streptococcal (after a strep infection).
What are the Causes / Risk Factors?
  • Post-streptococcal infection
  • Autoimmune (lupus)
  • IgA nephropathy
What are the Symptoms?
  • Hematuria (tea/cola-colored urine)
  • Mild proteinuria
  • Periorbital edema
  • Hypertension
  • ↓urine output
  • Recent strep infection
How is it Diagnosed?
  • Urinalysis (RBC casts, protein)
  • ↑ASO titer (post-strep)
  • ↑BUN/creatinine
  • Renal biopsy
What is the Treatment?
  • Treat infection (antibiotics if strep)
  • Manage BP; restrict sodium/fluid
  • Diuretics
  • Monitor renal function; usually supportive
NCLEX TipPost-strep glomerulonephritis: tea-colored urine + edema + HTN a few weeks after a strep throat or skin infection.
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Renal Calculi.

Renal
What is Renal Calculi?
  • Kidney stones — crystallized minerals in the urinary tract.
  • Most are calcium-based.
What are the Causes / Risk Factors?
  • Dehydration
  • High calcium / oxalate / purine intake
  • Immobility
  • Gout, hyperparathyroidism
What are the Symptoms?
  • Severe flank pain (renal colic) radiating to groin
  • Hematuria
  • N/V
  • Frequency, urgency
  • Diaphoresis, restlessness
How is it Diagnosed?
  • CT (non-contrast, definitive)
  • Urinalysis (hematuria)
  • KUB X-ray, ultrasound
What is the Treatment?
  • ↑fluids (2–3 L/day); STRAIN all urine
  • Pain control
  • Lithotripsy or surgical removal
  • Diet based on stone type; prevent recurrence
NCLEX TipStrain all urine to catch the stone for analysis. Push fluids and control the severe colicky pain.
© NCLEX Deck7 / 11

Benign Prostatic Hyperplasia.

Male GU
What is Benign Prostatic Hyperplasia?
  • Non-cancerous enlargement of the prostate.
  • Compresses the urethra → obstruction.
What are the Causes / Risk Factors?
  • Aging
  • Hormonal changes (DHT)
What are the Symptoms?
  • Weak stream, hesitancy
  • Frequency, urgency, nocturia
  • Incomplete emptying, dribbling
  • Urinary retention
  • Recurrent UTIs
How is it Diagnosed?
  • Digital rectal exam (enlarged prostate)
  • PSA (rule out cancer)
  • Urinalysis, post-void residual
What is the Treatment?
  • Alpha blockers (tamsulosin), 5-alpha reductase inhibitors (finasteride)
  • Avoid anticholinergics / decongestants (worsen retention)
  • TURP (surgery)
  • Post-TURP: monitor bleeding, continuous bladder irrigation
NCLEX TipBPH: alpha blockers (tamsulosin) relax the prostate. Avoid anticholinergics and decongestants — they worsen retention.
© NCLEX Deck8 / 11

Dialysis.

Chronic
Purpose
  • Removes wastes, excess fluid, and toxins when the kidneys fail
  • Hemodialysis (AV fistula/catheter) or peritoneal dialysis
AV Fistula Care
  • Assess for a thrill (feel) and bruit (hear) — patency
  • NO BP, blood draws, or IV in the fistula arm
  • Monitor distal circulation
Key Nursing Points
  • Hold certain meds (antihypertensives) before hemodialysis
  • Weigh before/after (fluid removed)
  • Peritoneal: cloudy return = peritonitis (infection)
  • Watch for hypotension and disequilibrium syndrome
NCLEX TipProtect the AV fistula: check for a thrill and bruit, and never use that arm for BP, IVs, or blood draws.
© NCLEX Deck9 / 11

Urinary Incontinence.

Bladder
What is Urinary Incontinence?
  • Involuntary loss of urine.
  • Types: stress, urge, overflow, functional.
What are the Causes / Risk Factors?
  • Weak pelvic floor (stress)
  • Overactive bladder (urge)
  • Retention / obstruction (overflow)
  • Immobility / cognition (functional)
What are the Symptoms?
  • Stress: leak with cough/sneeze/laugh
  • Urge: sudden strong urge
  • Overflow: dribbling, incomplete emptying
How is it Diagnosed?
  • History, bladder diary
  • Post-void residual
  • Urinalysis
What is the Treatment?
  • Pelvic floor (Kegel) exercises
  • Bladder training, scheduled voiding
  • Treat cause; anticholinergics (urge)
  • Skin care; weight loss; limit caffeine
NCLEX TipStress incontinence responds to Kegel exercises. Urge incontinence responds to bladder training / anticholinergics.
© NCLEX Deck10 / 11

Bladder Cancer.

Oncology
What is Bladder Cancer?
  • Malignancy of the bladder lining.
  • Hallmark: painless hematuria.
What are the Causes / Risk Factors?
  • Smoking (major)
  • Occupational dyes / chemicals
  • Chronic bladder irritation
  • Older age, male
What are the Symptoms?
  • Painless gross hematuria (classic)
  • Frequency, urgency, dysuria
  • Later: pelvic pain
How is it Diagnosed?
  • Cystoscopy with biopsy
  • Urine cytology
  • CT urogram
What is the Treatment?
  • Transurethral resection (TURBT)
  • Intravesical chemo / BCG
  • Cystectomy + urinary diversion (advanced)
  • Smoking cessation; ostomy care if diversion
NCLEX TipPainless hematuria is the classic sign of bladder cancer — always investigate it. Smoking is the biggest risk factor.
© NCLEX Deck11 / 11
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