Chapter 24 - Structure and Function of the Liver
When teaching a client about kidney disease, the nurse will mention that the average amount of filtrate formed each minute in a healthy kidney is how many milliliters?
125 mL
The nurse is educating a client about renal disease. Which percentage of cardiac output perfuses the kidneys?
22% to 25%
When the glomerular transport maximum for blood glucose is exceeded and its renal threshold has been reached, what happens to the excess glucose?
Spills into the urine
When teaching a class of nursing students, the pathophysiology instructor asks, "What is the majority of energy used for by the kidney?" Which response is most accurate?
Active sodium transport mechanisms.
A nurse is evaluating a client's morning laboratory values. Which result requires that the nurse notify the health care provider?
Creatinine: 10.6 mg/dL (937.04 µmol/L)
Recent evidence proposes that the use of which test may become useful as a marker of glomerular filtration rate because it is more sensitive and timely than creatinine levels?
Cystatin C
The filtration of blood undergoes several steps between the entry of blood into the kidney and the accumulation of urine. Which anatomical location begins the process of delivering blood for the filtration of blood and the flow of filtrate?
Interlobular artery
A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:
Decrease
A client is experiencing an increase in urinary output. Which physiologic response by the body is responsible for how the kidney concentrates urine?
Decrease in antidiuretic hormone
Which occurrence is most likely to cause increased urination?
Decrease in antidiuretic hormone
Which statement most accurately captures the function of the ascending loop of Henle?
Impermeability to water and absorption of solutes yields highly dilute filtrate.
The physician has prescribed a thiazide diuretic for a client. The nurse anticipates that the medication will:
block the tubular reabsorption of sodium.
A client in the hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine-collection test. The client asks the nurse why the test is necessary since the client provided a single urine sample 2 days prior. How could the nurse best respond?
"Often when an abnormal substance shows up in a urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."
When explaining to a CKD client how urea is absorbed, which transport mechanism will be mentioned?
Passive transport
Which factor is likely to result in decreased renal blood flow?
Stimulation of the sympathetic nervous system
Which components of glomerular filtrate can passively cross the tubular epithelial cell membrane?
Urea
In the presence of aldosterone in the distal tube, what action would occur?
The urine would be nearly sodium-free.
Which type of nephron is primarily responsible for concentrating urine?
Juxtamedullary nephrons
Which substance is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms?
Water
When explaining the body's compensatory mechanisms to maintain a normal pH, the health care provider knows that the renal system:
works slower than the respiratory system, going into action 1 to 2 days after H+ remain elevated.
A client expresses frustration at the inconvenience of having to collect urine for an entire day and night as part of a prescribed 24-hour urine collection test. The client asks the nurse, "Why is this test necessary since I gave a single urine sample 2 days ago?" How could the nurse best respond to this question?
"Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."
A client is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The client asks the nurse what this test is used for. What is the nurse's best response?
"This test provides a gauge of renal function."
The health care provider has ordered a urinalysis for a normally healthy client admitted to the hospital with dehydration. The client has been vomiting for the past 3 days and has had minimal oral intake. Upon analysis of the results, the urine specific gravity reflects:
1.040
What is the average amount of urine (in liters) produced daily by a man of average height and weight and in good health. Round your answer off to the nearest half liter (0.5 L).
1.5
A new client on hemodialysis is watching his blood being filtered through a dialyzer. He asks the nurse how much blood typically passes through the kidney every minute? The nurse responds:
1000-1300 mL/minute.
The nurse is caring for a critically ill client who requires measurement of hourly urine output. When assessing the urine output of the previous shift, the nurse recognizes that which volume reflects a minimum, normal urinary output?
60 mL/hour
A nurse is monitoring a client with renal failure. What glomerular filtration rate (GFR) would the nurse estimate if the creatinine clearance test result is 60 mL/min (1 mL/s/m2)?
60 mL/min
Urine is an amber, light-yellow fluid that is 5% dissolved solid. What percent of it is water?
95
Which client is benefiting from the renin-angiotensin-aldosterone mechanism?
A college student admitted to the neurotrauma unit following traumatic brain injury requiring surgery to evacuate a large hematoma
When explaining urinalysis results that show the presence of cast cells, the nurse informs the client that casts cells develop when the client has which urine abnormality? Select all that apply. A high protein concentration of the urine An elevated urine pH High urine osmolality More than one bacteria present in the urine
A high protein concentration of the urine High urine osmolality
In addition to regulating body fluids and electrolytes, the kidneys' endocrine function in maintaining bone calcium levels by doing which process?
Activating vitamin D
While studying for a renal test in pathophysiology class, a student helps a peer by reviewing facts about the cells of the proximal tubule. Which functions should be included in this discussion? Select all that apply. Aids in reabsorption Location for high-pressure capillary filtration Rich in mitochondria Plays a role in the medullary collecting tubule Supports active transport processes
Aids in reabsorption Rich in mitochondria Supports active transport processes
Which client on a geriatric medical unit is most likely to require slow-release potassium supplements on a regular basis? A 90-year-old woman who is taking an aldosterone antagonist to treat pulmonary edema An 81-year-old man who takes a thiazide diuretic to control his hypertension An 80-year-old man with congestive heart failure who is receiving a loop diuretic An 83-year-old woman who is taking an osmotic diuretic to address severe peripheral edema
An 81-year-old man who takes a thiazide diuretic to control his hypertension
When caring for the client in a shock state, the nurse recognizes that which compensatory substance may produce vasoconstriction of renal vessels? Select all that apply. Angiotensin II Antidiuretic hormone Endothelins Prostaglandins Nitric oxide
Angiotensin II Antidiuretic hormone Endothelins
A client with a traumatic amputation of the lower leg has lost >40% of blood volume and is currently not producing any urine output. The nurse bases this phenomena on which humoral substance that is responsible for causing severe vasoconstriction of the renal vessels?
Angiotensin II and antidiuretic hormone
It is known that high levels of uric acid in the blood can cause gout, while high levels in the urine can cause kidney stones. What medication competes with uric acid for secretion into the tubular fluid, thereby reducing uric acid secretion?
Aspirin
A client with a history of previous myocardial infarction (MI) has symptomology indicating ineffective renal blood vessel dilation, resulting in increased sodium retention. Which hormone level may have been affected by the MI?
Atrial natriuretic peptide (ANP)
Which substance released by atrial muscle cells will inhibit sodium and water reabsoption?
Atrial natriuretic peptide (ANP)
An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test.
BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L)
Protein and blood cell leakage into the filtrate that occurs in many forms of glomerular disease is a result of changes in the structure and function of which component of the glomerular?
Basement membrane
The nurse is performing palpation of the kidney during assessment of the client on the urology unit. The nurse plans to palpate in which area?
Between the 12th thoracic and 3rd lumbar vertebrae
A client has been prescribed hydrochlorothiazide, a thiazide diuretic, to control high blood pressure. While educating the client about the actions of the medication, the nurse will mention which actions of this medication?
Blocks Na+ reabsorption in distal tubules Increases active reabsorption of Ca++ into the blood
When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood?
Blood urea nitrogen
A dialysis technician is reviewing a textbook on kidney function. The technician would recognize which statements as characteristic of healthy kidneys? Select all that apply.
Blood vessels, nerves and, ureters all connect with the kidney at the hilus. Each kidney consists of lobes, with each lobe comprised of nephrons.
The elevated capillary hydrostatic pressure forces fluid and solutes out of the glomerular capillaries into what structure?
Bowman capsule
At which location in the nephron would a health care professional first expect filtrate to be largely free of plasma proteins?
Bowman's space
The nurse is analyzing the results of a client's urinalysis. Which results require the nurse to follow up as they represent abnormal results? Select all that apply. Amber-colored urine Casts present Bilirubin positive Leukocyte esterase negative Specific gravity 1.010
Casts present Bilirubin positive
The nurse is caring for a client with Addison disease. For which complication should the nurse monitor the client?
Elevations in potassium levels
The nurse is caring for a client who has sustained a cervical spinal cord injury with resulting muscle wasting due to immobility. Which alteration in the laboratory tests does the nurse recognize is consistent with decreased muscle mass?
Decreased creatinine levels
A client's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (12.85 mmol/L). Which factor may have contributed to this finding?
Dehydration
The nurse should anticipate that a client who collapsed while running his or her first marathon and has a urine specific gravity of 1.035 is experiencing:
Dehydration
The nurse is assessing a client who has come to the family practice clinic for an annual checkup. The nurse performs a dip stick of the client's urine for screening, which reveals glucose in the urine. The nurse recognizes this may occur with which medical problem?
Diabetes
When administering a thiazide diuretic the nurse recognizes these medications exert their effects in which area of the kidney?
Distal and collecting tubules
When caring for the client with kidney failure, the nurse anticipates that which laboratory test abnormalities will be present? Select all that apply. Elevated potassium Decreased calcium Increased creatinine Decreased BUN Decreased phosphate
Elevated potassium Decreased calcium Increased creatinine
The nurse is caring for a client with suspected dehydration. Which results does the nurse recognize will help confirm this diagnosis?
Elevated urine specific gravity
A nurse is teaching a client about the functions of the kidney. Which would be the most appropriate information for the nurse to provide? Select all that apply. Eliminates metabolic wastes Regulates calcium and phosphorus conservation and elimination Regulates blood pressure through the renin-aldosterone mechanism Regulates pH of body fluids through reabsorption and conservation Maintains homeostasis of red blood cells by production of estrogen Regulates osmolality of intracellular fluid through action of antidiuretic hormone (ADH)
Eliminates metabolic wastes Regulates calcium and phosphorus conservation and elimination Regulates blood pressure through the renin-aldosterone mechanism Regulates pH of body fluids through reabsorption and conservation
The nurse is teaching a group of nursing students about the major functions of the kidney. What should the nurse include in the discussion? Select all that apply.
Elimination of water Removal of waste products Removal of excess electrolytes
A nurse is caring for a client with end-stage renal failure who has symptoms of anemia. The nurse anticipates administering which intervention to increase red blood cell production?
Epoetin alfa
Which option identifies the function of the kidneys in maintaining normal composition of internal body fluids?
Filtration and reabsorption of physiologically essential substances
Urine specific gravity is normally 1.010 to 1.025 with adequate hydration. When there is loss of renal concentrating ability due to impaired renal function, low concentration levels are exhibited. When would the nurse consider the low levels of concentration to be significant?
First void in morning
The nurse is caring for a client with a disease causing excess antidiuretic hormone (ADH). When performing the assessment, the nurse should focus on which manifestation of excess ADH?
Fluid volume excess
Which condition causes an elevation in the level of blood urea nitrogen (BUN)?
Gastrointestinal bleeding
A client is hospitalized and being treated for an acute kidney injury. Which information is most useful to the nurse while evaluating for improvement in kidney function?
Glomerular filtration rate (GFR)
When caring for the client with proteinuria, the nurse recognizes that dysfunction in which structure of the kidney allows protein to leak into the urine?
Glomerulus
The nurse recognizes that antidiuretic hormone (ADH) exerts its effects in which location?
Loop of Henle
Which substance can be eliminated from the body by the kidneys as a means of regulating body acid-base balance when urine buffers are present?
Hydrogen (H+)
The nurse is teaching a group of nursing students about antidiuretic hormone. The nurse should include which point about the site of ADH production in the discussion?
Hypothalamus
The nurse and nursing student are caring for a client with kidney dysfunction who requires a test to determine glomerular filtration rate. The nurse recognizes that the student understands the test when the student states:
I will need to start a 24-hour urine collection.
The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. What is the most appropriate response by the nurse?
In renal disease, vitamin D is unable to be transformed to its active form.
The pathophysiology instructor will emphasize that the cells of the proximal tubule have a fine, villous structure that increases surface area, allowing for which physiologic function to occur with fluids? Select all that apply. Increase in reabsorption Provides a high-pressure capillary filtration system Supports active transport processes Reabsorbs nutrients into the blood Filters wastes from the body via urine
Increase in reabsorption Supports active transport processes
While taking her history on woman with a tentative diagnosis of diabetes mellitus, the client mentions she has been eating a lot of sweets lately. How would the nurse expect this diet to impact the client's renal system?
Increase renal blood flow
The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?
Increased creatinine and blood urea nitrogen (BUN) levels
Which client's laboratory result would be associated with abnormalities in kidney function? Select all that apply. An absence of protein in a urine sample Increased creatinine levels Urine gravity of 1.038 and normal serum creatinine levels Decreased blood urea nitrogen level (BUN) Detectable levels of glucose in a urine sample Elevated cystatin C level
Increased creatinine levels Detectable levels of glucose in a urine sample Elevated cystatin C level
The nurse is caring for a client who prefers to consume a large amount of protein in the diet. What does the nurse recognize may occur as a result of a high-protein diet?
Increased glomerular filtration rate
When teaching the client with gout about the cause of the disease, which cause should the nurse relate?
Increased levels of uric acid in the blood cause gout.
The nurse is caring for a client with profound dehydration. The nurse recognizes the body should release antidiuretic hormone (ADH) in this situation based on which type of feedback from the body?
Increased serum osmolarity
To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. Which rationale for this treatment is the most likely?
It removes water from the filtrate and returns it to the vascular compartment.
The major sites where aldosterone exerts its action on sodium reabsorption and potassium regulation occur in which tubule location?
Late distal and cortical collecting tubule
The health care provider has prescribed a diuretic to inhibit the Na+/K+/2Cl− cotransporters for a client. The nurse recognizes the medication as a:
Loop diuretic
A nurse educator is explaining the importance of maintaining GFR for the maintenance of homeostasis. Which of these plays an essential role in maintaining a constant GFR?
Macula densa
The nurse is administering a potent loop diuretic which blocks reabsorption of certain electrolytes. The nurse applies principles of pathophysiology when monitoring the client for deficiency of which substance in the blood?
Magnesium
A client in shock is experiencing a decrease in the glomerular filtration rate (GFR). What is the physiologic reason for the kidney to decrease GFR at this time?
Maintain urine-concentrating ability of the kidneys
Which aspect of kidney function is performed by the juxtaglomerular apparatus?
Matching changes in glomerular filtration rate (GFR) with renal blood flow
The nurse in the cardiac clinic is teaching a client about his antihypertensive medications when he mentions he has strained his back and is taking over-the-counter ibuprofen for relief. Which information does the nurse need to relate to this client?
Nonsteroidal anti-inflammatory drugs cause fluid retention and should be avoided in those with hypertension.
The nurse has delegated obtaining a urine specimen for testing to the nursing assistant. What does the nurse emphasize the assistant should do to ensure accuracy of testing?
Obtain a freshly voided specimen.
The nurse is instructing a client on the procedure for obtaining a voided urine specimen to bring the laboratory for analysis. What is the most important information for the nurse to tell the client?
Obtain the first morning specimen.
The nurse is explaining the role of endothelial cells in synthesizing vasoactive substances, one of which nitric oxide. What affect does nitric oxide have on renal blood flow?
Opens the renal vessels to increase blood flow
When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply.
Penicillin Aspirin Morphine sulfate
The nurse and nursing student are caring for a client with a condition causing deficiency of ADH. The nurse recognizes that the student understands the origin of this process when the student states ADH is produced in which area?
Pituitary gland
An older adult client with high blood pressure is prescribed a thiazide diuretic. What should the nurse expect to happen to this client's potassium and calcium levels?
Potassium level will drop, but calcium level may rise.
When teaching a pharmacology class the nurse relates that 65% of all reabsorptive and secretory processes that occur in the tubular system take place in which area?
Proximal tubules
The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?
Produce erythropoietin
Which physiologic process is performed by the kidneys and contributes to increased blood pressure?
Production and release of renin
The nurse is teaching a group of nursing students about the physiologic consequences of hypotension and reduced perfusion to the kidney. Which compensatory mechanism occurs immediately after renin release from the kidney?
Production of angiotensin I
The nurse would be most concerned when the glomerular filtrate contains:
Protein
While explaining the tubular role in reabsorption, the nurse will stress that a diet high in sodium intake will result in sodium reabsorption in which renal location?
Proximal convoluted tubule
The nurse is teaching a group of nursing students about the formation of urine in the nephron. Which component does the nurse teach is a component of the nephron? Select all that apply.
Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting tubule
Damage to which area of a nephron would most likely result in impaired secretion and reabsorption?
Proximal tubule
A client is diagnosed with gouty arthritis. To prevent the buildup of uric acid and recurrence of gout attacks, the nurse teaches the client to avoid eating foods containing which compound?
Purine
A client has experienced an increase in aldosterone secretion as a result of stimulation of the adrenal glands. The nurse anticipates which laboratory value response?
Reduction in urinary sodium levels
The nurse recognizes the kidney can be considered an endocrine organ as it may exert which action?
Regulation of red blood cells through manufacture of erythropoietin
An athlete has become dehydrated during a long race in hot weather. Which physiologic process will occur in an attempt to protect the athlete's extracellular fluid volume?
Release of antidiuretic hormone from the posterior pituitary
Many substances are both filtered out of the blood and reabsorbed into the blood in the kidneys. What is the plasma level at which a specific substance can be found in the urine?
Renal threshold
The kidney assists in blood pressure regulation by releasing which substance from the juxtaglomerular cells in response to decreased renal blood flow, causing efferent arteriole vasoconstriction?
Renin
An older adult man is brought into the clinic by his daughter, who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level?
Serum creatinine
Which blood test reflects the glomerular filtration rate (GFR) and is used to estimate renal function?
Serum creatinine
A client who has been diagnosed with Addison disease will likely experience which abnormal lab result related to the absence of aldosterone?
Serum potassium levels elevated
The nurse is caring for a client with Addison disease who has an absence of aldosterone. When reviewing the client's diagnostic test results, which consequence of low aldosterone levels does the nurse anticipate?
Serum potassium of 7.3 mEq/L (7.3 mmol/L)
The nurse is analyzing the results of a client's urinalysis. Which finding requires the need for follow-up by the nurse because it is an abnormal result?
Specific gravity 1.034
The renal clearance of any given substance (glucose, urea, creatinine, etc.) that is present in the filtrate is measured independently. What are the factors that determine renal clearance of a substance?
The ability of the substance to be filtered in the glomeruli The capacity of the renal tubules to reabsorb or secrete the substance
Diuretics can either block the reabsorption of components of the urine, or they can block the reabsorption of water back into the body. What does the increase in urine flow from the body depend on with a client taking diuretics?
The amount of sodium and chloride reabsorption that is blocked
The nurse is caring for a client with kidney disease who has an estimated glomerular filtration rate of 75 mL/minute. The nurse interprets this data in which way?
The client has reduced glomerular filtration, reflecting damage to the kidney.
While assessing a client with urosepsis, the nurse notes the client's blood pressure is 80/54 mm Hg; heart rate is 132 beats/min; respiratory rate is 24 breaths/min; pulse oximetry 89% on 6 lpm O2. Over the last hour, the clients' urine output is 15 mL. When explaining to a new graduate nurse, the nurse will explain which physiologic principle?
The client's sympathetic nervous system has been stimulated, which has resulted in vasoconstriction of the afferent arteriole that in turn causes a decrease in renal blood flow.
A medical client's routine urinalysis includes the following data: Casts: positive Red blood cells: negative Crystals: negative White blood cells: negative Epithelial cells: few Which interpretation of these findings is the most plausible?
The client's urine contains excessive protein.
The nurse is teaching an anatomy and physiology class to a group of nursing students. When discussing the juxtamedullary nephrons, it is correct to relate which function to the students?
The function of the juxtamedullary nephrons is to concentrate urine.
Which function of the kidneys helps to maintain the pH balance in the body?
The kidneys conserve base bicarbonate and eliminate hydrogen ions.
A health care provider is caring for an older adult client with a recent diagnosis of renal failure and an acid-base imbalance. The family asks, "What is the underlying cause of the renal failure?" Which phenomenon would most accurately answer the question?
The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body.
A client with a diagnosis of heart failure has begun showing signs of renal failure due to which change in the kidney?
The kidneys receive a high proportion of cardiac output to maintain GFR and waste-product removal.
The nurse is caring for a client who has produced an average of 20 mL/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output?
The kidneys should produce about 1.5 L of urine each day.
The nurse is teaching a group of nursing students about the mechanism of action of common diuretics. What best reflects the mechanism of these drugs?
They block the reabsorption of sodium and chloride in the nephron.
Which statements about mesangial cells within the glomerulus are accurate? Select all that apply. They cover the entire amount of endothelial cells contained within the capillaries. They have phagocytic properties that remove macromolecular materials. They exhibit vasodilator properties to assist with increase blood flow in times of stress. They enlarge (hyperplasia) in response to glomerular diseases. They are coiled and drain Bowman's capsule.
They have phagocytic properties that remove macromolecular materials. They enlarge (hyperplasia) in response to glomerular diseases.
Which diuretic acts by preventing sodium chloride reabsorption in the distal convoluted tubule?
Thiazide diuretics
Which diuretic acts by preventing the reabsorption of sodium chloride in the distal convoluted tubule?
Thiazide diuretics
Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume?
Thiazide diuretics
The nurse is administering the diuretic furosemide to a client with heart failure. The nurse recognizes that this exerts its action in which area in the kidney?
Thick ascending loop of Henle
A client is diagnosed with gout in the right foot and a kidney stone in the left ureter. The nurse recognizes these conditions may have resulted from accumulation of which chemical in the body?
Uric acid
A client has a routine urine sample during an annual checkup. Which results is an expected finding in a healthy individual?
Urine specific gravity of 1.020
In contrast to the descending limb, the ascending limb of the loop of Henle is impermeable to which substance that results in dilute tubular filtrate?
Water
The nurse administers the drug vasopressin to a client with a pituitary disorder. Based on knowledge of pathophysiology, the nurse anticipates the client will react in which way?
Water will be retained and decreased urine output will result.
A client arrives in the emergency department semi-comatose. Her breath has a "fruity" smell. Their initial blood glucose level is >600. Her mouth and mucous membranes are dry. The health care providers suspect the client may be experiencing hyperglycemic hyperosmolar syndrome. In this situation, the nurse can expect the client's lab results to reflect:
an increase in glomerular filtration rate [GFR].
A client has been prescribed a drug that is not removed quickly by renal filtration. The drug likely has this quality because it is:
bound to plasma proteins.
The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:
concentrate urine.
A client with a history of renal insufficiency is experiencing a flare-up of his arthritis and he has increased his daily dose of ibprofen (an NSAID). Knowing the effect that ibprofen has on prostaglandin synthesis, the nurse should anticipate:
decrease renal blood flow resulting in decrease in urine output.
In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:
innervation of the sympathetic nervous system, causing constriction of the afferent arteriole.
A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when stating that the mechanism of action of ACE inhibitors is to:
prevent conversion of angiotensin I to II.
Nitric oxide, a vasodilator produced by the vascular endothelium, is important in renal control by:
preventing excessive vasoconstriction. allowing normal excretion of sodium and water.
A client is admitted with worsening heart failure. The client is reporting frequent urination recently. The nurse knows that the physiology behind the body's response to decreased vascular volume by increasing urine output is due to:
release of atrial natriuretic peptide (ANP) from overstretched atria.
A client with Addison disease has been admitted to regulate fluid and electrolyte imbalances. The nurse can anticipate that the client's blood work will show:
serum potassium levels have increased.
In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:
significant decrease in urine output due to decrease in renal blood flow.
An automobile accident client is brought to the emergency department in hypovolemic shock from internal bleeding. Nurses are closely monitoring urine output since a significant decrease signifies that:
the SNS has caused afferent arteries to constrict to decrease blood flow.
A client with end-stage kidney disease has developed anemia. The nurse teach this client that the reason anemia has developed is:
the damaged kidney is unable to produce erythropoietin.
Clients with CKD are at risk for demineralization of their bones since they are no longer able to:
transform vitamin D to its active form.
