Pathophysiology : Kidney Lecture

The nurse is analyzing the results of a client's routine urinalysis. The nurse determines the results as normal when the specimen identified: A. albumin B. glucose C. creatinine D. protein

C. creatinine

Select the option that identifies the function of the kidneys in maintaining normal composition of internal body fluids. A. production of erythropoietin for RBC production B. excretion of the renin-angiotensin mechanism C. filtration and reabsorption of physiologically essential substances D. conversion of vitamin D to active form

C. filtration and reabsorption of physiologically essential substances

A client has experienced an increase in aldosterone secretion as a result of stimulation of the adrenal glands. The nurse anticipates which of the following responses? A. no change in Na levels B. excretion of Na in the urine C. reduction in urinary Na levels D. reduction in serum Na levels

C. reduction in urinary Na levels

How much ml of blood do the kidneys receive per minute?

1,000 - 1,200 mL ( ~ 20 - 25% of the cardiac output)

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 (dehydration is 1.030 - 1.040)

The health care provider has prescribed a diuretic to inhibit the Na/K/2Cl con transporters for a client. The nurse recognizes the medication as:

A loop diuretic

Select the percentage of cardiac output that perfuses the kidneys. A. 20 - 25% B. 25 - 30% C. 10 - 15% D. 15 - 20%

A. 20 - 25%

The nurse is instructing a client on the procedure for obtaining a voided urine specimens to bring the labor analysis. Which is the most important information for the nurse to tell the client? A. Obtain the first-voided morning specimen B. Obtain the specimen at night C. Obtain the specimen 2 days before coming to the lab D. Obtain the specimen 2 hours after eating

A. Obtain the first-voided morning specimen

Which function of the kidneys helps to maintain the pH balance in the body? A. the kidneys conserve base bicarbonate and eliminate hydrogen ions B. the proximal tubule actively secretes large amounts of different organic anions C. uric acid is freely filtered in the glomerulus and is absorbed and secreted into the proximal tubule D. the glomerulus freely filters Na and K, but unlike Na, K is reabsorbed from and secreted into the tubular fluid

A. the kidneys conserve base bicarbonate and eliminate hydrogen ions

Which condition causes an elevation in the level of BUN? A. Pituitary disease B. Gastrointestinal bleeding C. Excessive fluid intake D. Heart disease

B. GI bleeding

Which substance, related by the atria, causes vasodilatation of the afferent and efferent arterioles, which results in an increase in renal blood flow and glomerular filtration rate (GFR)? A. aldosterone B. atrial natriuretic peptide (ANP) C. antidiuretic hormone (ADH) D. angiotensin 1

B. atrial natriuretic peptide (ANP)

The physician has prescribed a thiazide diuretic for a client. The nurse anticipates that the medication will: A. block the tubular reabsorption of Na B. release antidiuretic hormone (ADH) C. decrease the GFR D. activate the renin-angiotensin system

B. block the tubular reabsorption of Na

An adult has a serum sample taken to evaluate the BUN - creatinine ratio. Select the result that indicates a normal test. A. bun 25 mg/dL to creatinine 1 mg/dL B. bun 10 mg/dL to creatinine 1 mg/dL C. bun 40 mg/dL to creatinine 2 mg/dL D. bun 30 mg/dL to creatinine 2.5 mg/dL

B. bun 10 mg/dL to creatinine 1 mg/dL (bun = 10:1)

Select the action of renin in the renin-angiotensin-aldosterone mechanism. A. breaks down insulin for exertion by the kidneys B. converts angiotensin to angiotensin I C. catabolizes angiotensin II to aldosterone D. increases reabsorption of Na in the distal tubule

B. converts angiotensin to angiotensin I

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. A. regulates osmolality of intracellular fluid through action of antidiuretic hormone B. eliminates metabolic wastes C. maintains homeostasis of RBCs by production of estrogen D. regulates BP through the renin-aldosterone mechanism E. regulates calcium and phosphorus conservation and elimination F. regulates pH of body fluids through reabsorption and conservation

B. eliminates metabolic wastes D. regulates BP through the renin-aldosterone mechanism E. regulates Ca and P conservation and elimination F. regulates pH of body fluids through reabsorption and conservation

The nurse is reviewing the most recent lab results of a client. The nurse would classify which of the following as abnormal? Select all that apply: A. carbon dioxide: 27 mEq/L B. phosphate: 4.5 C. chloride: 99 mEq/L D. potassium: 65 mEq/L E. calcium: 4.1 mg/dL F. pH: 7.23 G. creatinine: 2.6 mg/dL H. sodium: 140 mEq/L I. bun: 26 mg/dL

D. potassium: 6.5 mEq/L E. calcium: 4.1 mg/dL F. pH: 7.23 G. creatinine: 2.6 mg/dL I. bun: 26 mg/dL

A client is experiencing an increase in urinary output. The nurse determines this is a result of:

a decrease in antidiuretic hormone

A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be:

abnormal glomerular filtration

Which condition is often found in clients who have chronic renal disease?

anemia

There must be balance between extracellular fluid & intracellular fluid in order to maintain kidney....

homeostasis

What are the most common forms of kidney stones made from?

calcium oxalate

A client has just been admitted to the ED after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's GFR will:

decrease

The nurse would be most concerned when the GFR contains:

protein (protein is very large molecule so not good to have in GFR)

Where do kidney stones lodge in the body?

ureter

A client is admitted to the hospital with a diagnosis of gout in the right foot and a kidney stone in the left ureter. The nurse recognizes that these conditions may have resulted from accumulation of:

uric acid (product of purine metabolism)

Severe flank pain in is a possible symptom related to

urolithiasis