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31 Cards in this Set
- Front
- Back
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What are the 2 main functions of the kidneys?
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Filter blood
& Maintain fluid and electrolyte balance |
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What is erythropoietin?
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Hormone produced by the kidneys that stimulates RBC production in the bone marrow.
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When BP is low, renal perfusion is low, ECF is low, serum Na+ level is low, and urine Na+ level is high:
how does the renin-angiotensin-aldosterone system increase the BP? |
Renin:
-converts angiotensinogen to angiotensin I, which is then converted to angiotensin II by the angiotensin-converting enzyme. Angiotensin: -vasoconstriction -stimulates adrenal cortex to release aldosterone Aldosterone: -increases Na+ and H2O retention -excretes K+ through kidneys -increases ECF |
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What is atrial natriuretic peptide (ANP)?
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-A hormone secreted from cells in the right atrium in response to atrial distention due to an increase in plasma volume.
-Acts on the kidneys to secrete Na+ -Inhibits the effects of the renin-angiotensin-aldosterone system. -Results in production of large volume of dilute urine. -Causes relaxation of the afferent arteriole, thus increasing the GFR. |
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True or False:
Kidneys activate Vitamin D and prostaglandins. |
True
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What are prostaglandins?
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Prostaglandins have vasodilating action:
1) increases renal blood flow (decreases BP) 2) promotes Na+ excretion 3) counteracts vasocontrictors like angiotensin & norepinephrine 4) anti-inflammatory |
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The right kidney is lower than the left kidney, why?
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Because of the liver.
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Which kidney is palpable, left or right?
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The right kidney.
The left kidney should NOT be. |
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What is the functional unit of the kidneys?
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Nephron
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What is parenchyma?
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Actual kidney tissue
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What is cortex?
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Outer layer of the kidney
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What is medulla?
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Inner layer of the kidney
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What is the function of the nephron and the collecting duct?
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To reabsorb essential materials and secrete nonessential materials.
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How do we know if the nephrons are NOT being perfused?
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When the BP is low, in the 50s - 60s.
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The kidneys are able to filter approx. 2 quarts of blood per day if the BP is greater than what pressure?
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100
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The kidneys are very vascular, so what is the patient at risk for post-operation?
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Risk for bleeding
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How much urine output should be produced per hour?
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At least 30 mL
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What ABNORMAL lab value indicates significant decreased kidney functioning?
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Creatinine
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What other lab values may indicate how the kidneys are functioning?
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BUN (blood urea nitrogen)
BUN/Creatinine Ratio |
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What information should be collected in H&P?
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-Fluid intake
-Patterns of urination -Past problems w/UTI, even in childhood -Prostate problems -Medications -Mobility problems -Sexual history (gonnorhea, syphillis) -Work environment (hair dressers, painters - fumes = risk for bladder cancer) |
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At what angle should you perform a percussion of the kidneys?
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CV angle
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To palpate kidneys, deep palpation is performed bc usually, they are not easy to feel.
What position should you place the patient for the deep palpation? |
Supine (flat on their back)
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In urine analysis, what 4 products should NOT be present in urine?
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Glucose
Ketones Bilirubin Casts |
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In urinalysis, how much of RBC, WBC, and protein may be present in urine?
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RBC 0-4
WBC 0-5 Protein 0-18 |
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What is the normal range of lab value for specific gravity?
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1.003 - 1.030
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What does it indicate when the specific gravity value is HIGH?
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Patient is dehydrated
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What is the normal pH range for urine?
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4.0 - 6.0
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Increased foam in the Foley bag may indicate high presence of what product?
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Protein
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High presence of protein in urine indicates what?
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Glomerular injury
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What conditions may show sediments in urine?
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Increased ammonia
Problems with glomerular inner lining Rhabdomyolosis (lysis of muscle tissue) |
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Describe the clean catch urine collection process.
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Clean labia and urethral meatus 3 times with 3 cloths.
Wash hands b4 clean catch. Need at least 30 mL of urine. Must be fresh (15-20 minutes) |
