• can include pathophysiology, health assessment (normal and abnormal), and pharmacologic treatment
• Review required readings, course lectures, case
... [Show More] study and learning activity. Fluid and electrolyte balance- processes in the kidney
• Hormones controls reabsorption of fluid and electrolytes
o Antidiuretic hormone
▪ From posterior pituitary; controls reabsorption of water by altering permeability of distal convoluted tubule and collecting duct
o Aldosterone
▪ Secreted by adrenal cortex; controls sodium reabsorption and water by exchanging Na ions for K or hydrogen ions in distal convoluted tubule
o Atrial natriuretic hormone
▪ From heart; 3rd hormone controlling fluid balance by reducing Na and fluid reabsorption in kidneys
Renal circulation process
Laboratory testing- purpose and interpretation ; Age related urinary changes ; Conditions/diagnoses associated with urine color changes
Diagnostic test
• Urinalysis
o Constituents and characteristics of urine may vary w/ dietary intake, drugs, and care w/ which specimen is handled
o Urine is normally: clear, straw colored and has mild color
o Urine pH is 4.5-8.0
o Appearance
▪ Cloudy indicate presence of large amounts of protein, blood cells or bacteria and pus
▪ Dark color indicate hematuria (blood), excessive bilirubin content or highly concentrated urine
▪ Unpleasant or unusual odor indicate infection or result from certain dietary components or medications
o Abnormal constituents (present in significant quantities)
▪ Blood (hematuria)
• small (microscopic) amounts of blood indicates infection, inflammation, or tumors in urinary tract
• large numbers of RBC (gross hematuria) indicates increased glomerular permeability or hemorrhage in tract
▪ protein (proteinuria, albuminuria)
• indicates leakage of albumin or mixed plasma proteins into filtrate d/t inflammation and increased glomerular permeability
▪ bacteria (bacteriuria) and pus (pyuria)
• indicates infection in urinary tract
▪ urinary casts (microscopic sized molds of tubules, consisting of one or more cells (bacteria, protein, and so on))
• indicates inflammation of kidney tubules
▪ specific gravity
• indicates ability of tubules to concentrate the urine
• very low specific gravity= dilute urine; related to renal failure
▪ glucose and ketones (ketoacids)
• found when DM is not well controlled
• blood test
o elevated serum urea (BUN and Cr)
▪ indicate failure to excrete nitrogen wastes d/t decreased GFR
▪ results from protein metabolism
o metabolic acidosis (decreased pH and Bicarb)
▪ indicate decreased GFR and failure of tubules to control acid-base balance
o anemia (low hgb)
▪ indicated decreased erythropoietin secretion and/or bone marrow depr [Show Less]