Chapter 24 (Level 31-40): Structure and Function of the Liver

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.

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

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 -Synthesis of insulin -Removal of red blood cells

-Elimination of water -Removal of waste products -Removal of excess electrolytes

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 -Renal pelvis

-Proximal convoluted tubule -Loop of Henle -Distal convoluted tubule -Collecting tubule

Which substance released by atrial muscle cells will inhibit sodium and water reabsoption?

Atrial natriuretic peptide (ANP)

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 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

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

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 nurse recognizes that antidiuretic hormone (ADH) exerts its effects in which location?

Loop of Henle

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

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

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

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

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

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

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

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 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.

Which function of the kidneys helps to maintain the pH balance in the body?

The kidneys conserve base bicarbonate and eliminate hydrogen ions.

Which substance is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms?

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.

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.