Renal stone, polyuria, weakness, hypercalcemia is a result of

SGPGI Nursing Officer-2023

Medical & Surgical Nursing

Medium

Appeared in: SGPGI Nursing Officer-2023

Explanation

an overactive Hyperparathyroid gland, a condition known as hyperparathyroidism.
This condition involves the excessive secretion of parathyroid hormone (PTH), which is the primary regulator of calcium in the body.
Excess PTH pulls calcium from the bones and increases its reabsorption by the kidneys and intestines, leading to high blood calcium levels (hypercalcemia).
Hypercalcemia directly causes the symptoms listed: renal stones (from high urine calcium), polyuria (as kidneys try to excrete excess calcium), and muscle weakness (due to altered neuromuscular function).

Option B: A hypo-parathyroid gland (hypoparathyroidism) produces too little PTH, which results in low blood calcium levels (hypocalcemia).
Option C: An overactive thyroid gland (hyperthyroidism) primarily affects the body's metabolic rate, causing symptoms like weight loss, rapid heartbeat, and heat intolerance. It does not typically cause hypercalcemia.
Option D: An underactive thyroid gland (hypothyroidism) slows down the body's metabolism, leading to symptoms like weight gain, fatigue, and cold intolerance. It does not affect calcium levels in this way.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Parathyroid Disorders as background academic context rather than a clinical decision trigger.
Nurses must monitor patients with hyperparathyroidism for complications like kidney stones and cardiac dysrhythmias. This includes straining all urine to check for stones.
Patient safety is a priority. Due to muscle weakness and potential bone demineralization, the patient is at high risk for falls and fractures. The nurse should implement fall precautions.
Encouraging a high fluid intake (e.g., 2-3 liters per day, if not contraindicated) is a key nursing intervention to help prevent the formation of renal stones by diluting the calcium in the urine.

How to Approach the Question

First, identify the key terms in the question: 'Renal stone,' 'polyuria,' 'weakness,' and 'hypercalcemia.'
Recognize that this is a cluster of symptoms and a specific lab finding.
Connect the lab finding, hypercalcemia (high calcium), to the endocrine system, which regulates electrolytes.
Recall the glands involved in calcium regulation. The parathyroid glands are the primary regulators of blood calcium.
Deduce that an overactive ('hyper') parathyroid gland would lead to high PTH and consequently high calcium (hypercalcemia).
Match this deduction with the given options to select 'Hyperparathyroid gland' as the cause.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 28-30

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 1095-1097, 1092-1094