A 22-year-old male who has lost a large amount of blood following a workplace injury

A 41-year-old female who is admitted for intravenous antibiotic treatment of pyelonephritis

A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and congestive heart failure

A 20-year-old male who is admitted for treatment of an overdose of a nephrotoxic drug

A 68-year-old male with a diagnosis of benign prostatic hyperplasia (BPH)

An 80-year-old female who has been admitted for treatment of dehydration, hyponatremia, and malnutrition

Loss of appetite and complaints of nausea

Muscular spasms and complaints of cramps

High fluid intake and urine output

Lethargy and stupor

She is susceptible to isotonic fluid volume deficit and hypernatremia as a result of water losses.

She is prone to isotonic fluid volume excess due to impaired osmolality from sodium losses.

She could develop third-spacing edema as a result of plasma protein losses.

She is at risk of compensatory fluid volume overload secondary to gastrointestinal water and electrolyte losses.

Proximal convoluted tubule

Bowman space

Loop of Henle

Afferent arteriole

“Nephrons are delicate structures that cannot endure the high pressure that exists in capillary beds elsewhere in the body.”

“Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation.”

“Dilation of the afferent arteriole allows more blood into the nephron and increases the glomerular filtration rate.”

“The glomerulus is located between an arteriole and a venule that work together to regulate blood flow.”

Arterial blood gas sampling is likely to indicate a pH in the range of 7.45 to 7.55.

Her kidneys are likely to reabsorb H+ and secrete HCO3–.

Her body may be producing excess metabolic CO2.

Her kidneys will adapt with an increase in plasma HCO3– and her pH will decrease.

A 60-year-old man with a history of cardiovascular disease who is recovering in the hospital from a coronary artery bypass graft

A 66-year-old man undergoing dialysis for the treatment of chronic renal failure secondary to hypertension

A 38-year-old man with high urine output due to antidiuretic hormone insufficiency

A 30-year-old obese woman with poorly controlled diabetes mellitus

An inordinate amount of interstitial fluid is accumulating in the patient’s abdomen.

The transcellular component of the intracellular fluid compartment contains far more fluid than normal.

The normally small transcellular fluid compartment, or third space, is becoming enlarged.

Gravity-dependent plasma is accumulating in the patient’s peritoneal cavity.

Water

Sodium

Phosphate

Calcium

Neurologic diseases like MS often result in flaccid blaIDer dysfunction.

She may be unable to sense her blaIDer filling as a result of her MS.

Lesions of the basal ganglia or extrapyramidal tract associated with MS inhibit detrusor contraction.

Pathologic reductions in blaIDer volume brought on by MS necessitate frequent micturition.

“Your diet may have played a part in this, but in fact genetics is likely primarily to blame.”

“What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved.”

“You likely don’t need to change your diet, but now that you have stones in one kidney, you’re at very high risk of growing them in the other kidney.”

“Your diet might be normally healthy, but high intake of normally beneficial minerals like calcium and magnesium can lead to stones.”

Exchange of Na+ and H+ ions

Selective renal secretion and reabsorption of CO2

Phosphate and ammonia buffer systems in the renal tubules

Excretion of HCO3– by the kidneys

An 81-year-old man with right-sided heart failure and hypothyroidism

A 60-year-old obese female with a diagnosis of poorly controlled diabetes mellitus

A 34-year-old industrial worker who has suffered extensive burns in a job-related accident

A 77-year-old woman who has an active gastrointestinal bleed and consequent anemia

A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa

An 81-year-old female patient with osteoporosis and anemia

A 77-year-old patient with urinary retention due to benign prostatic hyperplasia (BPH)

A 55-year-old woman with a recent stroke secondary to long-standing hypertension

A 60-year-old man with a systemic fungal infection requiring intravenous antibiotics

Uroflowmetry to determine to rate of the patient’s urine flow

Ultrasound blaIDer scanning to determine the residual volume of urine after voiding

Renal ultrasound aimed at identifying acute or chronic kidney disease

Urinalysis focusing on the presence or absence of microorganisms, blood, or white cells in the man’s urine

Conservation or formation of new HCO3– by the kidneys

Low albumin and plasma globulin levels

Transcompartmental exchange of H+ and potassium ions

Renal excretion of HCO3– in the presence of excess base

Cholinergic actions of the cold medicine are triggering internal and external sphincter contraction.

Antihistamine effects inhibit communication between the pons and the thoracolumbar cord.

The anticholinergic effects of the medication are impairing normal blaIDer function.

Over-the-counter medications such as cold medicine stimulate the parasympathetic nervous system and inhibit blaIDer emptying.

Gastric lavage

Syrup of ipecac

Fomepizole

Sodium bicarbonate

Stress incontinence due to damage to CNS inhibitory pathways

Overactive blaIDer that may result from both neurogenic and myogenic sources

Overactive blaIDer due to intravesical pressure exceeding urethral pressure

Overflow incontinence that can result from displacement of the angle between the blaIDer and the posterior proximal urethra

Alterations in blood pH, peripheral edema

Increased nitrogenous waste levels, decreased glomerular filtration rate (GFR)

Decreased serum creatinine and blood urea nitrogen (BUN), decreased potassium and calcium levels

Decreased urine output, hematuria, increased GFR

Hypertrophy of the blaIDer muscle and increased blaIDer wall thickness

Decreased urine production and nitrogenous wasted excretion by the kidneys

Decompensation, blaIDer stretching, and high residual urine volume

Overflow incontinence and loss of contraction power

A 32-year-old woman who had a healthy delivery of her third child 4 months ago

A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH)

A 55-year-old man with diabetes who is receiving diuretic medications for the treatment of hypertension

A 30-year-old woman who has been diagnosed with gonorrhea

A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation

A 20-year-old man who has spina bifida and consequent impaired mobility

UTIs coupled with an impaired immune response have caused her ADPKD.

She has inherited a tendency for epithelial cell in her tubules to proliferate inappropriately.

Severe hypertension and portal hypertension are likely precursors.

She has inherited undersized kidneys that are prone to calculi formation.

Low O2 levels, increased anion gap, base excess

High ammonia levels, decreased anion gap, high potassium

Increased CO2, increased anion gap, base deficit

Decreased CO2, decreased anion gap