Renal Disorders, Dialysis, & Kidney Care — Anatomy, AKI, CKD, and NCLEX Nursing Interventions | Chapter 51: Saunders NCLEX-PN Review

Renal Disorders, Dialysis, & Kidney Care — Anatomy, AKI, CKD, and NCLEX Nursing Interventions | Chapter 51: Saunders NCLEX-PN Review

Chapter 51 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides an in-depth study of the renal system, from kidney anatomy and nephron function to complex renal disorders, dialysis procedures, and transplant care. This chapter emphasizes fluid and electrolyte balance, diagnostic interpretation, and NCLEX-priority nursing interventions for safe renal care.

Watch the lecture above for a complete renal system review, then follow the detailed study notes below to prepare for the NCLEX-PN exam.

Saunders NCLEX-PN Examination Review book cover

Kidney Anatomy & Physiology

  • Nephron structure — glomerulus, Bowman’s capsule, tubules
  • Functions — filtration, reabsorption, secretion, urine formation
  • Hormonal regulation — ADH, aldosterone, renin-angiotensin-aldosterone system
  • pH balance — bicarbonate buffer system, acid-base homeostasis

Diagnostic Tests

  • Serum creatinine, BUN, GFR — primary renal function markers
  • Urinalysis — protein, specific gravity, casts
  • Imaging — KUB, renal ultrasound, IV pyelogram (check iodine allergy)
  • Renal biopsy — bleeding precautions and post-procedure care

Acute Kidney Injury (AKI)

  • Causes — prerenal, intrarenal, postrenal
  • Phases — oliguric, diuretic, recovery
  • Nursing care — fluid balance, electrolyte management, renal diet

Chronic Kidney Disease (CKD)

  • Stages — from mild damage to end-stage renal disease
  • Complications — anemia, bone disease, cardiovascular issues
  • Uremic syndrome — nitrogen retention, neurologic changes, pruritus

Dialysis Therapies

  • Hemodialysis: AV fistula/graft care, infection prevention, fluid removal
  • Peritoneal dialysis: CAPD, CCPD; dialysate exchange steps, peritonitis prevention
  • CRRT — for critically ill patients with unstable hemodynamics

Electrolyte Imbalances in Renal Disorders

  • Hyperkalemia — peaked T waves on ECG, insulin/glucose or calcium gluconate for treatment
  • Hypermagnesemia — respiratory depression, reflex loss
  • Hypocalcemia — muscle spasms, Chvostek’s and Trousseau’s signs

Urinary & Prostatic Conditions

  • UTI, cystitis, urethritis, pyelonephritis — causes, symptoms, antibiotics
  • BPH — urinary retention, TURP care, prevention of TURP syndrome

Renal Calculi

  • Types — calcium, uric acid, struvite, cystine
  • Prevention — hydration, dietary changes, control of underlying conditions
  • Treatments — lithotripsy, surgery, nephrostomy tube care

Kidney Transplantation

  • Donor-recipient matching, surgery steps
  • Immunosuppressive therapy — cyclosporine, tacrolimus
  • Rejection signs — fever, graft tenderness, decreased urine output

NCLEX Nursing Priorities

  • Strict fluid intake and output monitoring
  • Daily weights for fluid balance
  • Electrolyte lab interpretation and correction
  • Infection prevention in all catheter and access care
  • Comprehensive patient education — diet, activity, medication adherence

Conclusion

Renal disorders demand precise assessment, timely interventions, and expert client teaching. Chapter 51 provides the NCLEX-PN candidate with the knowledge needed to manage AKI, CKD, dialysis, and transplant care with confidence.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and study resources.

View the full Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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