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48 Cards in this Set
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- Back
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ADH
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Stimulates reabsorption of water, resulting in increased extracellular fluid volume, decreased as osmolality. Release of ADH is also stimulated by hypovolemia, fever, certain medications, and severe emotional or physical stress.
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Where does ADH work
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In the distal convoluted tubule and collecting ducts of the nephron
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Aldosterone
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Secreted by adrenal cortex. Works in the distal convoluted tubule of the nephron to pull additional sodium from the filtrate into the intravascular compartment, which also causes water to be reabsorbed increasing extracellular volume
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Factors causing the release of aldosterone
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Stimulated by angiotensin II, factors affecting the release of aldosterone include hypovolemia, hyponatremia, hyperkalemia and severe emotional or physical stress.
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ANP atrial natriuetic peptide
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Acts by blocking the production of aldosterone and ADH by causing the kidneys to increase sodium and water excretion, triggered by hypernatremia, hypervolemia, vasoconstriction, and decreased cardiac output.
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What is the primary role of the nephron
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Remove metabolic wastes and maintain fluid and electrolyte balance
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Which hormone secreted by the kidneys controls the erythrocyte production in the bone marrow
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Erythropoietin
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Regulation of blood flow through the kidney is not dependent on the
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Glomular filtration rate
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The best way to determine the Glomular filtration rate is to obtain
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A 24 hour urine creatinine clearance
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BUN
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Measures the amount of urea nitrogen resulting from protein metabolism. Normal values 7 – 18 MG/DL
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Reasons for BUN elevation
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Dehydration; high-protein diet; hi catabolic state – severe infection, surgery, trauma; poor renal perfusion – decreased GFR; renal dysfunction
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Creatinine
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Normal byproduct of muscle metabolism; in normally functioning kidney all creatinine that is produced each day should be excreted. Normal 0.5 – 1.5 MG/DL
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Conditions that would cause decreased creatinine
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Decreased muscle mass/elderly; liver disease; malnutrition
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Conditions that would cause increased creatinine
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Increased protein intake/meat; exercise; renal failure; medications – cimetidine, trimethoprim.
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Normal specific gravity of urine
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1.005 – 1.030ate
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the presence of either red blood cells, protein or glucose in the urine indicate
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Red blood cells – signals infection, obstruction, trauma or cancer
Protein – signals renal failure, glomerular arthritis, or myoglobin from the breakdown of muscle tissue in Burns and trauma. Glucose – signals elevated serum glucose c D K A, |
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Diagnostic tests ordered to assess renal function
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serum osmolality, normal 275 – 295.
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Gold standard for the measurement of renal function
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Creatinine clearance test
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Serum creatinine is a normal byproduct of
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Muscle metabolism
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The gold standard of renal function measurement is
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Creatinine clearance
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An IV pyelogram
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Uses a dye hat becomes visible immediately after injection
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Which test is utilized to identify a renal etiology of high blood pressure
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Renal arteriogram
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A renal ultrasound is used to diagnose following three Items
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Source of abdominal pains, such as kidney stones. Infection inthe kidneys or bladder. Problems related to the prostate gland.
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Dilution or concentration of filtrate occurs in this section of the nephron
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Loop of Henle
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Water and electrolytes are reabsorbed in this area of the nephron whereas waste products such as urea nitrogen and creatinine remain in the filtrate
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Proximal convoluted tubule
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What are the two distinct spaces or compartments that contain body fluid
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Intracellular and extracellular compartments
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The entire blood volume of a person is filtered
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60 to 70 times a day
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– Plays a role in regulating Renal bloodflow by responding to a drop in systemic blood pressure by releasing epinephrine
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Sympathetic nervous system stimulation
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When pressure in the afferent arterial decreases the – is activated resulting in constriction of the Efferent arterial thereby increasing the GFR
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Activation of the RAAS
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The etiology or clinical presentation of patients with hypermagnesemia include all of the following except: pancreatitis. Decreased deep tendon reflexes. Respiratory arrest. Drowsiness, lethargy, and coma.
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Pancreatitis
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The etiology or clinical presentation of patients with hypomagnesemia includes all of the following except: chronic malnutrition. Alcoholism. Drowsiness, lethargy, and coma. Malabsorption syndrome
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Drowsiness, lethargy, and coma
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The management of the patient with a potassium imbalance would include
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Restricting dietary sources of potassium
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The signs and symptoms of water deficit parallel those of
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Hypernatremia
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Patients with saline deficit will present with
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Tachycardia, decreased urine output, renal failure
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Patients with water intoxication will exhibit
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Confusion, anorexia, decreased serum Osmolality
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Patient hypertensive from septic shock and has an acute renal failure. Nurse anticipates renal replacement therapy ordered would most likely be
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CVVH
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Nurse notes patient with chronic hypertension has creatinine of 1.2, double from prior admission four months ago. Suspecting patient developing diminished Renal reserve, appropriate nursing action would be
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Review patient's medications for any nephrotoxic Agents
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Which hormone is secreted in response to an increased serum osmolality
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Antidiuretic hormone
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The etiology or clinical presentation of patients with hypercalcemia includes all of the following except: serum calcium equal 7.8. Bones, moans, groans, stones. Weakness, lethargy, fatigue. Polyurea, polydipsia, Nocturia
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Serum calcium equals 7.8
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CHVoste K's sign indicates which electrolyte disturbance
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Hypocalcemia
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CR RT maybe used in ICU for treatment of acute and chronic renal failure. Driving force used to move blood from patients through dialyzing device
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M a P
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€46 patient developed renal failure following a cardiac cathetetrization. This type of kidney failure is most likely
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Intrarenal
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Normal BUN
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7 to 18
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Reasons for elevated BUN
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Dehydration, high-protein diet, high catabolic state, severe infection surgery trauma, Poor renal perfusion, decreased GFR,renal dysfunction
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Normal creatinine
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0.5 – 1.5
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Which of the following is not an important role for sodium: potassium regulation, water regulation, influences on the acid/based balance, functional integrity of cell membrane
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Functional integrity of cell membranes
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The most common cause of hypercalcemia is
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Increased release from the bone
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Which of the following EKG changes may be a result of hypermagnesemia: ventricular ectopy. Shortening of the QT interv. Heart block, sinus arrhythmia. Peak t wave
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Heart block, sinus arrhythmia
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