1. What major hormone does kidney make? What does it cause? Why will a patient in CKD often develop anemia?
? Aldosterone: (hormone from adrenal cortex)
... [Show More] Increases reabsorption of Na and excretion of K; Controlled by renin-angiotensin-aldosterone system
CKD: decreased erythropoietin production= anemia: feel very weak and tired because of this;
2. What structures are in the kidney? Where do many diuretics work? What happens in glomerulonephropathy?
Major structures of the kidney:
1) Renal Capsule
2) Renal Parenchyma: Cortex & Medulla
3) Renal pyramidrenal calyxrenal pelvis
4) Uretersbladderurethra
5) Renal arteries
6) Renal veins
Diuretics work within the kidney tubules (inhibit reabsorption, therefore increasing urine output)
Glomerulonephropathy: any noninflammatory disease of the renal glomeruli;
Glomerulonephritis: inflammation of glomerular structures Significance: leading cause of chronic renal failure in US Etiology: exact cause unknown
3. What's the tie between DVT (VTE) and pulmonary embolism? Major s/s each. Pulmonary Embolism: Occlusion of a pulmonary blood vessel by an embolus; Patients at risk: post-surgical patients, patients with arrhythmias; Recognition & prompt treatment of a PE is ESSENTIAL! Once a thrombus dislodges & becomes an emboli & lodges in a pulmonary vein, blood flow is obstructed, leads to: atelectasis, decreased perfusion, right-sided HF, and cardiopulmonary arrest;
S/S: tachypnea, dyspnea, chest pain, cough, hemoptysis, diaphoresis, anxiety, impending sense of doom; Diagnostic tests: D-dimer, V/Q scan, CT, pulmonary angiography
Deep Vein Thrombosis: DVT can move into pulmonary vasculature; the formation of a thrombus in association with inflammation in the vein; the most common disorder of the veins;
S/S: leg pain or swelling may occur but there may be no symptoms
4. What are the intrinsic rates for SA and AV nodes.
SA node: fires an impulse between 60-100bpm (depolarizes faster than other cells in the heart and is therefore responsible for pacing the heart)
AV node: 40-60bpm (important that the conduction is slower the further you go down the conduction system)
5. Know about ammonia, bilirubin, BUN, creatinine, uric acid, who gets rid of them, if they are elevated what conditions might they be associated with? Ammonia: a nitrogen waste resulting from protein metabolism in the intestine or liver, is removed from the blood and converted to urea,
enabling it to be excreted by the kidneys; correlates with hepatic encephalopathy;
BUN: BUN stands for “blood urea nitrogen.” Urea is a nitrogenous end product of protein metabolism. Urea is filtered by the kidneys and found in urine. The serum concentration of urea nitrogen serves as index of renal function. BUN test values are affected by protein intake, tissue breakdown, and fluid volume changes, however. (When elevated: not good kidney function) could be falsely elevated if dehydrated, exercised, or increased protein
Creatinine: endogenous waste product of skeletal muscle = filtered actively and passively at the glomerulus, passed thru tubules with little change, then excreted in the urine. Measuring creatinine clearance is a good measure of the glomerular filtration rate (GFR= rate of creating initial filtrate which is called ”ultrafiltrate”); so it is a good measure of overall renal function. As renal function declines, creatinine clearance decreases indicating less filtration or removal of waste products
Uric Acid: Uric acid is a byproduct of purine metabolism (can accumulate in the case of gout). [Show Less]