CCTC NUR 210 UNIT 3 GU QUESTIONS AND ANSWERS 2024

CCTC NUR 210 UNIT 3 GU QUESTIONS AND ANSWERS 2024 Functions of the Kidney: •Urine formation •Excretion of waste products •Regulation of electrolytes and acid-base balance •Control of water balance and BP •Renal clearance •Regulation of RBC production •Synthesis of vitamin D to active form •Secretion of prostaglandins nephron- located within the renal parenchyma. They are a structural and functional unit of the kidney responsible for urine formation glomerulus- tuft of capillaries forming part of the nephron through which filtration occurs. It is enclosed in an epithelial structure called the Bowman capsule what branches to form a glomerulus? the afferent arterioles What does blood leave the glomerulus through to flow back to the inferior vena cava? efferent arterioles When does renal replacement need to be considered? when the functioning nephrons is less than 20% of normal where are Cortical Nephrons located? 80%-85% are located in the outermost part of the cortex where are juxtamedullary nephrons located? 15%-20% are located deeper in the cortex What are juxtamedullary nephrons distinguished by? long lops of Henle and are surrounded by long capillary loops called vasa recta that dip into the medulla of the kidney Order in which the filtrate, created in the bowman capsule, travels: first into the proximal tubule, then the loop of Henle, the distal tubule, and either the cortical or the medullary collective ducts. Where is the site of renin production? the juxtaglomerular apparatus Renin- Hormone directly involved in the control of arterial BP What prevents the reabsorption of urine in the ureters? transitional epithelium called urothelium The three areas in the ureters that are prone to obstruction by renal calculi or stricture: the ureteropelvic junction, the ureteral segment near the sacroiliac junction, and the ureterovesical junction. micturition- urination Three step process of urine formation: golmerular filtration, tubular reabsorption, and tubular secretion Substances normally filtered by the glomerulus, reabsorbed by the tubules, and excreted in the urine include: sodium, chloride, bicarbonate, potassium, glucose, urea, creatinine, and uric acid. Amino acids and glucose are usually filtered where? at the glomerulus and reabsorbed so that neither is excreted in the urine renal glycosuria- excretion of glucose in the urine when does renal glycosuria occur? if the amount of glucose in the blood and glomerular filtrate exceeds the amount that the tubules are able to reabsorb. what does filtration through the glomerulus depend on? adequate blood flow that maintains a consistent pressure through the glomerulus called hydrostatic presure What can alter the blood flow through the glomerulus? hypotension, decreased oncotic pressure in the blood, and increased pressure in the renal tubules from an obstruction filtrate- fluid that passes from the blood through the capillary walls of the glomeruli of the kidney What does the filtrate consist of? water, electrolytes, and other small molecules. Larger molecules stay in the bloodstream. Where does the second and third steps of urine formation occur? in the renal tubules Tubular secretion occurs when substances move from where? from the peritubular capillary blood plasma into the tubular lumen (filtrate) Tubular secretion helps with the elimination of: potassium, hydrogen ions, ammonia, uric acid, some drugs, and other waste products. Where does filtrate become concentrated? distal tubule and collecting ducts under hormonal influence and becomes urine What would occur if there was no tubular reabsorption? volume depletion How do the kidneys regulate BP? Specialized vessels of the kidney, called the vasa recta, constantly monitor blood pressure as blood begins its passage into the kidney. When the vasa recta detect a decrease in blood pressure, specialized juxtaglomerular cells near the afferent arteriole, distal tubule, and efferent arteriole, secrete the hormone renin. Renin converts angiotensinogen to angiotensin I, which is then converted to angiotensin II—the most powerful vasoconstrictor known; angiotensin II causes the blood pressure to increase. The adrenal cortex secretes aldosterone in response to stimulation by the pituitary gland, which occurs in response to poor perfusion or increasing serum osmolality. The result is an increase in blood pressure. When the vasa recta recognize the increase in blood pressure, renin secretion stops. Aldosterone- hormone synthesized and released by the adrenal cortex; causes the kidneys to reabsorb sodium. Less sodium is excreted in the urine. *How many mL in 1 lb.?* 500 mL in 1lb. *renin-angiotensin-aldosterone system:* -the liver releases a hormone called angiotensinogen -the kidney releases an enzyme called renin -together renin and angiotensinogen make angiotensin I -when angiotensin I gets to the lungs, the lungs release ACE -ACE and Angiotensin I make angiotensin II -Angiotensin II gets to the adrenal glands and aldosterone is released -Aldosterone increased reabsorption of Na (which increases fluid) and increases BP. Aldosterone decreases potassium by removing it in the urine -Angiotensin II works in the kidneys by causing vasoconstriction in the arterioles which causes increase in BP How do the kidneys regulate acid-base balance? reabsorbs and returns bicarbonate from the urinary filtrate to the body's circulation, excrete or reabsorb acid, synthesize ammonia, and excrete ammonium chloride. renal clearance- ability of the kidneys to clear solutes from the plasma what is useful in measuring the renal clearance? creatinine clearance Creatinine- an endogenous waste product of skeletal muscle that is filtered at the glomerulus, passed through the tubules with minimal change, and excreted in the urine. Glomerular Filtration Rate (GFR)- amount of plasma filtered through the glomeruli per unit of time How to calculate the creatinine clearance? 24 hour urine specimen collected. Midway through the collection, the serum creatinine level is measured. (volume of urine[mL/min] X urine creatinine[mL/dL])/(serum creatinine[mg/dL]) is the formula used to calculate the creatinine clearance. How does the kidneys regulate RBC production? When the kidneys detect a decrease in the oxygen tension in renal blood flow, because of anemia, arterial hypoxia, or inadequate blood flow, they release erythropoietin. Erythropoietin is a glycoprotein from the kidney that stimulates the bone marrow to produce red blood cells conscious awareness of bladder filling occurs as a result of which nervous system? sympathetic