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NURS617 EXAM 6 Questions and
Correct Answers the Latest Update
nephron + parts of nephron
✓ -functional unit of the kidney; consists of the following:
✓ -glomerulus: cluster of tiny blood vessels; filters blood & selectively reabsorbs
material into blood, secretes others to be secreted in urine via hydrostatic pressure
✓ -bowman capsule: filtrates; GRF
✓ -basement membrane: within glomerulus; determines permeability of solutes
✓ -tubular components: proximal tubule, loop of henle, distal convoluted tube,
collecting tubule (SEE OTHER NOTE FOR ROLES OF EACH)
✓ **NO ABILITY TO REGENERATE NEPHRONS; older age=decreased
nephrons=decreased kidney function
4 parts of the nephron tubule + roles: in order
✓ 1. proximal tubule: drains bowman capsule; reabsorption of electrolytes
✓ 2. loop of henle: where ADH exerts effects; urine volume/concentration
✓ 3. distal convoluted tubule: reabsorb Na+, Cl-, Ca+2, Mg+2
✓ 4. collecting tubule: joins tubules to collect filtrate for urine; where aldosterone
exerts Na+ reabsorption & K+ secretion; where thiazide diuretics inhibit Na+
reabsorption
juxtaglomerular complex: role
✓ -increase in BP=vessels relax in kidneys
✓ -decrease in BP=vessels constrict in kidneys
3 feedback mechanisms to keep blood flow + GFR consistent
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✓ 1. autoregulation/myogenic response: intrinsic ability of arteries to constrict when
blood pressure rises and to vasodilate when it decreases.
✓ 2. humoral: vasoconstriction (angiotensin II/ADH/endothelines) or vasodilation
(dopamine, NO, prostaglandins)
✓ 3. tubuloglomerular feedback (TGF): controls rate of renin release (enzyme needed
to convert angiotensinogen to angiotensin II; also increases Na+ reabsorption via
adrenal stimulation to release aldosterone)
✓ **kidneys receive 20-25% of cardiac output
3 factors: how kidneys produce concentrated or dilute urine
✓ 1. osmolarity: exchange of solutes between descending and ascending loops loops of
henle + capillaries in medullary kidney
✓ 2. ADH + its actions: ADH present=water reabsorbed, ADH absent=water excreted
into urine
✓ 3. water permeability: increase in permeability=decrease in urine flow +
concentration
✓ *kidneys also regulate pH via conserving or eliminating H+
renal clearance
✓ -volume of plasma cleared each minute of any substance that finds its way into urine
✓ -urine concentration x urine flow (mL/min)
✓ -determined by ability of substance to be filtered, secreted, or reabsorbed
✓ -glucose=not normally detected in urine; reabsorbed in tubules
addison's disease + kidneys
✓ -adrenal glands do not produce enough of the hormones cortisol or aldosterone
✓ -causes increase in K+, decrease in Na+ d/t increase in diuresis; leads to
hypotension, shock
Atrial Natriuretic Peptide (ANP): role on kidney function
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✓ -promotes vasodilation/acts as diuretic; secreted by cells of atria (heart)
✓ -helps conserve Na+ by inhibiting aldosterone
✓ -increases GFR & renal blood flow
renin-angiotensin-aldosterone system
✓ -decreased blood pressure causes the juxtaglomerular cells of kidneys to secrete
renin - converts angiotensinogen (inactive) to angiotensin I (active) which is then
converted into angiotensin II by angiotensin-converting enzyme (ACE)
✓
✓ -Angiotensin II stimulates the adrenal cortex to secrete aldosterone
✓
✓ -leads to absorption of Na and increased blood pressure
✓
✓ -once blood pressure is restored, there is a decreased drive to stimulate renin
release
high uric acid: causes + CI
✓ -gout, kidney stones; product of protein metabolism
✓ -rate of reabsorption exceeds secretion
✓ -CI: aspirin, thiazide + loop diuretics (d/t low extracellular fluid & increased uric acid
reabsorption)
Loop Diuretics: examples + action + AE
✓ -furosemide, bumetanide, torsemide
✓ -non potassium sparing
✓ -acts on ascending loop of henle
✓ -AE: hypokalemia, ototoxicity (lasix)
osmotic diuretics: examples + action + AE
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✓ -mannitol
✓ -acts on proximal tubule
✓ -AE: hypotension, hypovolemia
Thiazide diuretics: examples + action + AE
✓ -HCTZ, chlorothiazide
✓ -early distal tubule
✓ -AE: hyperuricemia, hypokalemia
Potassium sparing diuretics: examples + action + AE
✓ -aldactone, amiloride, eplerenone
✓ -aldosterone agonists; decrease na+ reabsorption, decrease k+ secretion
✓ -AE: hyperkalemia
GFR: stages of kidney disease
✓ 1-- Normal : > 90
✓ 2-- Mildly decreased: 60 - 89
✓ 3-- Moderately decreased: 30-59
✓ 4-- Severely Decreased: 15-29
✓ 5-- Kidney Failure (requires dialysis): < 15
renal function tests
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NURS617 EXAM 6 Questions and
Correct Answers the Latest Update
nephron + parts of nephron
✓ -functional unit of the kidney; consists of the following:
✓ -glomerulus: cluster of tiny blood vessels; filters blood & selectively reabsorbs
material into blood, secretes others to be secreted in urine via hydrostatic pressure
✓ -bowman capsule: filtrates; GRF
✓ -basement membrane: within glomerulus; determines permeability of solutes
✓ -tubular components: proximal tubule, loop of henle, distal convoluted tube,
collecting tubule (SEE OTHER NOTE FOR ROLES OF EACH)
✓ **NO ABILITY TO REGENERATE NEPHRONS; older age=decreased
nephrons=decreased kidney function
4 parts of the nephron tubule + roles: in order
✓ 1. proximal tubule: drains bowman capsule; reabsorption of electrolytes
✓ 2. loop of henle: where ADH exerts effects; urine volume/concentration
✓ 3. distal convoluted tubule: reabsorb Na+, Cl-, Ca+2, Mg+2
✓ 4. collecting tubule: joins tubules to collect filtrate for urine; where aldosterone
exerts Na+ reabsorption & K+ secretion; where thiazide diuretics inhibit Na+
reabsorption
juxtaglomerular complex: role
✓ -increase in BP=vessels relax in kidneys
✓ -decrease in BP=vessels constrict in kidneys
3 feedback mechanisms to keep blood flow + GFR consistent
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✓ 1. autoregulation/myogenic response: intrinsic ability of arteries to constrict when
blood pressure rises and to vasodilate when it decreases.
✓ 2. humoral: vasoconstriction (angiotensin II/ADH/endothelines) or vasodilation
(dopamine, NO, prostaglandins)
✓ 3. tubuloglomerular feedback (TGF): controls rate of renin release (enzyme needed
to convert angiotensinogen to angiotensin II; also increases Na+ reabsorption via
adrenal stimulation to release aldosterone)
✓ **kidneys receive 20-25% of cardiac output
3 factors: how kidneys produce concentrated or dilute urine
✓ 1. osmolarity: exchange of solutes between descending and ascending loops loops of
henle + capillaries in medullary kidney
✓ 2. ADH + its actions: ADH present=water reabsorbed, ADH absent=water excreted
into urine
✓ 3. water permeability: increase in permeability=decrease in urine flow +
concentration
✓ *kidneys also regulate pH via conserving or eliminating H+
renal clearance
✓ -volume of plasma cleared each minute of any substance that finds its way into urine
✓ -urine concentration x urine flow (mL/min)
✓ -determined by ability of substance to be filtered, secreted, or reabsorbed
✓ -glucose=not normally detected in urine; reabsorbed in tubules
addison's disease + kidneys
✓ -adrenal glands do not produce enough of the hormones cortisol or aldosterone
✓ -causes increase in K+, decrease in Na+ d/t increase in diuresis; leads to
hypotension, shock
Atrial Natriuretic Peptide (ANP): role on kidney function
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✓ -promotes vasodilation/acts as diuretic; secreted by cells of atria (heart)
✓ -helps conserve Na+ by inhibiting aldosterone
✓ -increases GFR & renal blood flow
renin-angiotensin-aldosterone system
✓ -decreased blood pressure causes the juxtaglomerular cells of kidneys to secrete
renin - converts angiotensinogen (inactive) to angiotensin I (active) which is then
converted into angiotensin II by angiotensin-converting enzyme (ACE)
✓
✓ -Angiotensin II stimulates the adrenal cortex to secrete aldosterone
✓
✓ -leads to absorption of Na and increased blood pressure
✓
✓ -once blood pressure is restored, there is a decreased drive to stimulate renin
release
high uric acid: causes + CI
✓ -gout, kidney stones; product of protein metabolism
✓ -rate of reabsorption exceeds secretion
✓ -CI: aspirin, thiazide + loop diuretics (d/t low extracellular fluid & increased uric acid
reabsorption)
Loop Diuretics: examples + action + AE
✓ -furosemide, bumetanide, torsemide
✓ -non potassium sparing
✓ -acts on ascending loop of henle
✓ -AE: hypokalemia, ototoxicity (lasix)
osmotic diuretics: examples + action + AE
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✓ -mannitol
✓ -acts on proximal tubule
✓ -AE: hypotension, hypovolemia
Thiazide diuretics: examples + action + AE
✓ -HCTZ, chlorothiazide
✓ -early distal tubule
✓ -AE: hyperuricemia, hypokalemia
Potassium sparing diuretics: examples + action + AE
✓ -aldactone, amiloride, eplerenone
✓ -aldosterone agonists; decrease na+ reabsorption, decrease k+ secretion
✓ -AE: hyperkalemia
GFR: stages of kidney disease
✓ 1-- Normal : > 90
✓ 2-- Mildly decreased: 60 - 89
✓ 3-- Moderately decreased: 30-59
✓ 4-- Severely Decreased: 15-29
✓ 5-- Kidney Failure (requires dialysis): < 15
renal function tests
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