Pathophysiology Chapter 32 kidney
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. Explanation: In the adult, the kidneys are perfused with 1000 to 1300 mL of blood per minute, or 20% to 25% of the cardiac output. p849
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 Explanation: The kidneys are paired, bean-shaped organs that lie outside the peritoneal cavity in the back of the upper abdomen, one on each side of the vertebral column at the level of the 12th thoracic to 3rd lumbar vertebrae. p842
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 Explanation: The juxtaglomerular cells contain granules of inactive renin, an enzyme that functions in the conversion of angiotensinogen to angiotensin I. With release of converting enzyme, angiotensin II is released, aldosterone is secreted, and extracellular volume increases. p852
Which blood test reflects the glomerular filtration rate (GFR) and is used to estimate renal function?
Serum creatinine Explanation: Serum creatinine level is used to estimate functional capacity of the kidneys. Increased creatinine level indicates decreased GFR and renal function. Blood urea nitrogen (BUN) levels are influenced by hydration status, protein intake, and bleeding, in addition to renal function. Serum ammonia is a metabolic by-product of urea and can be influenced by multiple factors unrelated to kidney function. p857
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 Explanation: The thick ascending loop of Henle is the site of the powerful "loop" diuretics such as furosemide, which exert their action by inhibiting the Na+/K+/2Cl cotransporters. p848
Nitric oxide, a vasodilator produced by the vascular endothelium, is important in renal control by: Select all that apply.
preventing excessive vasoconstriction. allowing normal excretion of sodium and water. Explanation: Nitric oxide, a vasodilator produced by the vascular endothelium, appears to be important in preventing excessive vasoconstriction of renal blood vessels and allowing normal excretion of sodium and water. Prostaglandins do not appear to play a major role in regulating renal blood flow. Some medications like aspirin and NSAIDs inhibit prostaglandin synthesis. p851