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NURS 5315 Test 5 (Module 10) Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NURS 5315 Test 5 (Module 10) Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NURS 5315 Test 5 (Module 10)Nephron structure - ANS - Glomerulus- collection of capillaries and is responsible for filtering
blood, reabsorbs amino acids, bicarb, sodium, chloride, phosphate, potassium, water
- Proximal tubule- can excrete phosphate, site of action for angiotensin II which stimulates
sodium, water and bicarb reabsorption.
- Descending loop of Henle- passively reabsorbs water, concentrates urine.
- Ascending loop of Henle- actively reabsorbs sodium, potassium, chloride, induces
reabsorption of magnesium and calcium, impermeable to water, therefore, makes water more
dilute.
Distal convoluted tubule- actively reabsorbs sodium, permeable to water, causes urine to be
more dilute. Site of action for ADH hormone and aldosterone
Renal blood vessels - ANS Autoregulation- autoregulation affects amount of blood flow to
kidneys and also rate of filtration. Decrease in arterial blood pressure and decrease in arterial
blood volume causes a decrease in renal perfusion. Decreased perfusion causes reduced GFR,
and decrease in fluid and sodium in distal tubule. This decrease is sensed by JGA which sends
signals to relax blood vessels in order to help bring blood to glomeruli, JGA releases renin which
converts angiotensin to angio I, this passes through lungs and stimulates release of angiotensin
converting enzyme. ACE converts angio I to angio II, which stimulates vasoconstriction to help
increase glomerular back pressure and increase GFR. Angio II is also responsible for
stimulating release of aldosterone. This results in additional reabsorption of water, increased BP
and increased GF rate.
aging effect on kidneys - ANS Reach adult size by adolescence
Hypertrophy with older age, reduced ability to excrete urine, hyperkalemia from reduced
excretion, more glucose excreted because of decreased reabsorption (not necessarily indicator
of diabetes), drugs not clearing as easily, harder to activate vitamin d, which affects calcium
absorption.
GFR- increased directly after birth, reaches adult levels by age 2, more dilute urine up to 6mo of
age, renal blood flow and GFR decrease with older age (d/t atherosclerosis)
Nephron- decrease in number and size with age (atherosclerosis), number of nephrons at age
75 decreased by 30%.
Tubular system- immature in infants (harder to excrete potassium, reabsorb bicarb, buffer
hydrogen), matures by age 2. Tubular atrophy is common with age.
Bladder- descends into pelvis after birth, may not be void for 12-24 hours following birth.
Frequency and nocturia are common with age.
, Renal injury - ANS Focal- localized, <50% of glomeruli affected
Diffuse- >50% of glomeruli affected *most common*
Primary glomerular disease- cause is directly related to the kidney - infection, ischemia, free
radicals, drugs, toxins, vascular disorders
Secondary glomerular disease- injury caused by mechanism outside the kidney (lupus,
diabetes), typically as a consequence of system disease like HF, SLE, HTN.
Patterns of kidney injury - ANS Hypercellularity- increased number of cells in glomerulus,
usually follows immune or inflammatory process
Basement membrane thickening- walls of glomerulus are thickening
Hyalinosis- accumulation of homogenous and eosinophilic cells in the glomerular capillaries,
usually are a result of capillary wall injury. Common in focal segmental glomerulosclerosis.
Sclerosis- collection of extracellular matrix, happens in diabetes
Nephrolithiasis - ANS Kidney stones from the urine being over saturated with particular ions
The opposite charged ions bond and form salts/crystals. If complete obstruction-
hydronephrosis and renal failure.
5mm or less may pass, 1 cm or larger will not pass.
Risks- <50, men, caucasian, gout, dehydration, high protein diet (increased purine intake), high
sodium diet (d/t increased calcium secretion), HTN
Causes- calcium are most common (hypercalciuria or hyperparathyroidism from increase in
osteoclast activity), struvite (chronic UTIs), uric acid (excess purine intake and gout), cystine
(less common and usually occur in kids)
S/S- flank pain that radiates to groin, anuria if obstruction, hematuria
Complications- renal injury and failure
Acute Kidney Injury - ANS Sudden decline in kidney function with a decrease in GFR and
accumulation of nitrogenous waste products in the blood
Increase in serum creatinine and blood urea nitrogen
50-80% mortality rate
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