UP NHM CHO 7 Sept 2022(shift-1st)
Medical & Surgical Nursing
Easy
Which of the following is an early manifestation of polycystic kidney disease?
Appeared in: UP NHM CHO 7 Sept 2022(shift-1st)
Explanation
- Haematuria, or blood in the urine, is a hallmark early sign of Polycystic Kidney Disease (PKD).
- It occurs when the fluid-filled cysts, which progressively enlarge the kidneys, rupture and bleed into the urinary collecting system.
- This can be visible to the naked eye (gross haematuria) or only detectable by urinalysis (microscopic haematuria).
- Along with haematuria, hypertension and flank pain are the most common initial presentations of the disease.
Why Other Options Were Wrong
- Option A: Polyuria (excessive urination) is a symptom of declining renal function and impaired urinary concentration, which are features of advanced or late-stage kidney disease, not an early manifestation of PKD.
- Option B: Patients with PKD characteristically develop hypertension (high blood pressure), not hypotension. The enlarging cysts compress renal arteries, leading to ischemia and activation of the renin-angiotensin-aldosterone system (RAAS), which raises blood pressure.
- Option D: Stress incontinence is the involuntary loss of urine due to increased intra-abdominal pressure. Its cause is related to pelvic floor muscle weakness, not the pathophysiology of polycystic kidneys.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Early clinical manifestations of Polycystic Kidney Disease (PKD) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a vital role in managing PKD by monitoring for key signs: regularly checking blood pressure, performing urinalysis for haematuria and proteinuria, and assessing for pain.
- Patient education is crucial, focusing on the importance of strict blood pressure control to slow disease progression, recognizing signs of complications like UTIs or cyst infections, and understanding the genetic nature of the disease for family planning (genetic counseling).
- What if? If a patient with known PKD presents with haematuria accompanied by fever and severe flank pain, the nurse should suspect an infected or ruptured cyst. This is a serious complication requiring immediate medical evaluation, blood cultures, and initiation of antibiotic therapy.
How to Approach the Question
- First, identify the key concepts in the question: 'early manifestation' and 'polycystic kidney disease (PKD)'.
- Recall the basic pathophysiology of PKD: the kidneys develop multiple, enlarging, fluid-filled cysts.
- Think about the direct, early consequences of these growing cysts. They can press on things, get big enough to rupture, or interfere with blood flow.
- Evaluate the options:
- Rupture would cause bleeding (Haematuria).
- Pressing on renal arteries would activate RAAS (Hypertension).
Concept Tested & Keywords
- Concept Tested: Early clinical manifestations of Polycystic Kidney Disease (PKD)
- Stem keywords: early manifestation, polycystic kidney disease
- Lead-in keywords: Which of the following
Question ID
QBhOvalmYZVEmzFxMJ0oCO
Reference Book
E6 Medicine Macleod Clinical Examination 15e p. 278-280
E6 Medicine Davidson Principles Practice 24e p. 425-427
Practise the full UP NHM CHO 7 Sept 2022(shift-1st)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Urinary Tract Function Questions
- Assessing the laboratory findings which results would the nurse most likely to expect to find in a client with chronic renal failure?
- A nurse is taking care of Chronic renal dysfunction patient. What diet she will advise for this patient?
- The following are the use of the central line catheter; EXCEPT:
- The involuntary loss of urine through an intact urethra as a result of sudden increase in the intra-abdominal pressure is called:
- Which of the following is the warning sign post renal transplantation?
- What is contraindicated in male patient reporting the symptoms of redness and ecchymosis in the scrotum region?
- A patient with low urine specific gravity will have all the following characteristics; EXCEPT:
- Food contraindicated with CRF and spironolactone:
- When initiating the use of a newly inserted Central Venous Access Device (CVAD), what is the recommended syringe size for the initial flushing proced…
- Which fluid used to inflate in a urinary Catheter balloon?
More UP NHM CHO 7 Sept 2022(shift-1st) Questions
- Foetal infection of a pregnant woman with syphilis can be diagnosed by:
- If a pregnant woman's BMI is 32, then the woman is diagnosed to be:
- An unregistered primipara woman with a history of no ANC and immunisation, has delivered a male baby in the labour room. She was tested to be Rh-nega…
- The care organised for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and…
- The irregular, pink, depressed linear marks seen over the lower abdomen and the thighs during pregnancy are known as \ \ \ \ \ \ .
- Name the structure formed from the union of the ampulla of the ductus deferens and the duct of the seminal vesicle
- Which of the following maternal haemoglobinopathies causes non-immune foetal hydrops?
- Which of the following is NOT a benefit of Kegel exercises?
- The introduction of the services of an ASHA worker is an example of which of the following?
- Prevention and control of locally endemic diseases is the key function of: