Urinary

Question 1

I/O

Answer 1

intake and output.
method of evaluating the renal system
totaled at the end of each 24 hour period

Question 2

average adult water intake

Answer 2

2500 cc/day

Question 3

water is excreted from?

Answer 3

kidney
lung
skin
feces

Question 4

urine output amount

Answer 4

up to 2000/day

Question 5

hourly rate of urine output

Answer 5

> 30 mL/hr

Question 6

function of the kidney

Answer 6

1. maintain proper fluid volume
2. secrete renin - regulates BP
3. electrolyte composition
4. acid/base balance
5. produce calcitriolto help maintain bone homeostasis
6. secrete erythropoietin - stim RBC production

Question 7

Creatinine

Answer 7

waste product from muscle metabolism

Question 8

creatinine reabsorption in tubule

Answer 8

for excretion

1.4 g

Question 9

nephron processes

Answer 9

1. glomerular filtration - filters blood
2. tubular secretion
3. tubular fluid reabsorption - includes 99% of water

Question 10

urea

Answer 10

final stage breakdown of amino acids from proteins

Question 11

urea reabsorption in tubule

Answer 11

25.0 g

Question 12

creatinine absorption into peritubular capillary

Answer 12

0 g

Question 13

urea absorption into peritubular capillary

Answer 13

28.0 g

Question 14

water absorption into peritubular capillary

Answer 14

178.5 L

Question 15

ADH release results in ?

Answer 15

holding water

Question 16

process of renin angiotensin system

Answer 16

renin is secreted as a result of decreased renal perfusion pressure and/or decreased salt delivery to Kd tubules =>
renin release with angiotensinogen in Lv => angiotensin I =>
combines with converting enzyme from Lu => angiotensin II =>
1. increased BP (prostaglandin release; vasoconstriction; increase myocardial contraction)
2. renal autoregulation
3. increased circulatory volume (aldosterone and ADH release; Na back in; K out)

Question 17

factors stimulating ADH release

Answer 17

1. falling blood volume
2. sympathetic stimulation
3. rising Na levels

Question 18

ADH

Answer 18

produced by hypothalamus
store in posterior pituitary
maintains fluid balance (water retention)

Question 19

isotonic solutions

Answer 19

same as body fluids
no shift in fluid occurs between ECF and ICF
normal saline

Question 20

isotonic solutions

Answer 20

same as body fluids
no shift in fluid occurs between ECF and ICF
normal saline - 1 L of NS expands Plasma by 0.25 L

Question 21

hypertonic solutions

Answer 21

water moves INTO ECF

Question 22

hypotonic solutions

Answer 22

water moves INTO ICF

Question 23

which electrolytes are supplied by diet and supplements

Answer 23

K and Mg

Question 24

which electrolyte levels are regulated by Kd function

Answer 24

Na and K

Question 25

normal range of K

Answer 25

3.5-5 mEq/L

Question 26

normal range of Na

Answer 26

135-145 mEq/L

Question 27

normal range of K

Answer 27

3.5-5 mEq/L

Question 28

normal range of Na

Answer 28

135-145 mEq/L reabsorbed at proximal convoluted tubule passive diffusion

Question 29

normal range of Cl

Answer 29

95-105 mEq/L

Question 30

normal range of PO

Answer 30

2.8-4.5 mg/dL

Question 31

normal range of Mg

Answer 31

2.0-3.0 mg/dL

Question 32

normal range of K

Answer 32

3.5-5 mEq/L 65% reabsorbed at Bowman's capsule and PCT 25-30% reabsorbed at ascending loop of Henle

Question 33

Na/Cl pump

Answer 33

Cl is reabsorbed in ascending loop of Henle and distal tubule Na is reabsorbed with Cl Pump is blocked by Thiazide and Loop diuretics

Question 34

Carbonic anhydrase

Answer 34

catalyst that influences Na reabsorption at proximal tubule. allows CO2 + H20= > carbonic acid H2CO3 => HCO3 + H + Na

Question 35

HCO3

Answer 35

bicarbonate stored in Kd used to modify the body's acid base balance

Question 36

H+ ion

Answer 36

makes urine acidic

Question 37

aldosterone

Answer 37

1. a hormone produced in adrenal glands that influences sodium and fluid levels 2. released in response to high K levels, sympathetic stim or angiotensin II 3. blocked by K sparing diuretics 4. stimulates Na/K pump in distal tubule

Question 38

countercurrent mechanism

Answer 38

regulates Na, concentrates or dilutes urine

Question 39

acidosis s/s

Answer 39

``` CNS sx lethargy confusion depression leading to coma Kd retains HCO3 use NaHCO3 IV drop for acidosis ```

Question 40

alkalosis s/s

Answer 40

``` Kd will excrete HCO3 nervousness hyperactive reflex convulsions IV NaCl with KCl can reverse severe - treat with ammonium chloride ```

Question 41

vit D

Answer 41

regulates Ca absorption in Gi tract | activated in Kd to promote Ca absorption

Question 42

Ca

Answer 42

maintains by PTH and calcitonin | fine tuning occurs in distal convoluted tubule

Question 43

erythropoietin

Answer 43

release from juxtaglomerular cells in Kd due to decrease in O2 regulates RBC production renal failure => anemia

Question 44

acute Kd failure

Answer 44

reversible | may be identifiable cause ie: Kd stone

Question 45

chronic Kd failure

Answer 45

progressive, irreversible etiology: hypertension, DM, pylonephritis needs dialysis, transplant

Question 46

Kd failure indications

Answer 46

low urine output 20 mg/dl | poor creatinine clearance (0.6-1.2 mg/dl)

Question 47

indications for diuretic use

Answer 47

1. edema assoc with CHF 2. acute pulmonary edema 3. Lv dz - cirrrhosis => ascites 4. Kd dz 5. hypertension 6. conditions that cause hyperkalemia

Question 48

normal urine osmolarity

Answer 48

500-800 mOsm/kg

Question 49

specific gravity of urine

Answer 49

1.010-1.020 g/mL

Question 50

normal blood osmolarity

Answer 50

275-295 mOsm/kg | thickness of blood

Question 51

treatment of hyperkalemia

Answer 51

Sodium polystyrene sulfonate (kayexalte) causes massive diarrhea to push K+ out PO or enema

Question 52

UTI treatment

Answer 52

block spasm of UB decrease pain protect cells from irritation treat enlargement of prostate

Question 53

Lv enzymes

Answer 53

ALT - 6-59 units/L AST - 10-34 units/L alkaline phosphatase - 44-147 units/L

Question 54

bilirubin

Answer 54

0.2-1.9 mg/dl breakdown of HB measures functional status of Lv turns feces brown and urine yellow

Question 55

PT/PTT

Answer 55

measures clotting factors | 30-40seconds/11-12.5 sec

Question 56

Lv enzymes

Answer 56

ALT - 6-59 units/L AST - 10-34 units/L alkaline phosphatase - 44-147 units/L enzymes rise when Lv is stressed