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NURS549 Chap 18-22 Exam Study Set

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NURS549 Chap 18-22 Exam Study Set
The majority of filtered water & sodium is reabsorbed in what segment of the nephron?

Proximal Convoluted Tubule

Loop of Henle

Distal Convoluted Tubule

Collecting Duct - Answer Proximal Convoluted Tubule

Proximal Convoluted Tubule :

•Reabsorption:

-100% of amino acids, water soluble vitamins and glucose ( Na+ / Glucose
Co-Transporter)

-80-90% of bicarbonate ions

-60 to 70% of filtered Water, Na+, K+; ( majority in PCT)

-50% of Cl-.

•Secretion:

-H+, urea, ammonia, and creatinine into tubular lumen.

Ordinarily, when blood glucose levels are normal, the excreted urine contains no
glucose because the kidneys are able to reclaim (reabsorb) all of the filtered glucose
back into the bloodstream at the proximal convoluted tubule.

t/f - Answer true

Thiazide Diuretics inhibit what Active Transport Pump in the luminal membrane of the
Distal Convoluted Tubule?

Na+ / Glucose Co-Transporter

Na+ / H + Countertransporter

Na+ K+/2CL- Cotransporter

Na+ / Cl- Cotransporter

Na+ / K+ Exchange Pump - Answer Na+ / Cl- Cotransporter

The thiazide diuretics act mainly in the distal tubule to decrease the reabsorption of
Na+----apparently by inhibition of the Na+/Cl- Cotransporter on the luminal membrane of
the distal convoluted tubule giving an increased concentration of Na+ and Cl- in the

,tubular fluid. ( and water passively follows)

Loop Diuretics inhibit the of Na+/K+/2Cl- Cotransporter in the luminal membrane of the
Descending Limb of the Loop of Henle.

t/f - Answer false

Loop diuretics inhibit the of Na+/K+/2Cl- Cotransporter in the luminal membrane of the
Ascending limb of the Loop of Henle

Potassium Sparring Diuretics act on the aldosterone regulated sodium-potassium
exchange pump which is associated with what segment of the nephron?

Proximal Convoluted Tubule

Ascending Limb of the Loop of Henle

Descending Limb of the Loop of henle

Distal Tubule/Collecting Duct - Answer Distal Tubule/Collecting Duct

. Na+/K+ exchange pump - (indirectly) moves Na+ out( reab) and K+ into ( secretion)
tubules (distal tubule &collecting duct).( aldosterone regulated)

Match the Diuretic Drug with the Diuretic Drug Class

1. furosemide

2. Hydrochlorothiazide

3. Spironolactone ( Aldactone )

4. mannitol

a. osmotic diuretic

b loop diuretic

c potassium sparing diuretic

d thiazide diuretic - Answer 1. b

2. d

3. c

4a

The combination diuretic drug DYAZIDE is a combination of:

A potassium sparing drug ( Spirolactone) and a loop diuretic ( Furosemide)

A potassium sparing drug ( Spirolactone) and a thiazide diuretic ( Hydrochlorothiazide)

, A loop diuteric drug ( Furosemide) and a thiazide diuretic drug( Hydrochlorothiazide)

A potassium sparing drug ( Triamterene) and a thiazide diuretic ( Hydrochlorothiazide) -
Answer A potassium sparing drug ( Triamterene) and a thiazide diuretic (
Hydrochlorothiazide)

Triamterene - Triamterene directly blocks the epithelial sodium channel (ENaC) on the
lumen side of the kidney collecting tubule, resulting in a decrease in NA+/K+ Exchange

•Ability to block exchange not dependant on Aldosterone

•Used in conjuction with HCTZ ( Dyazide)

Hyperuricemia is associated with all of the following classes of diuretics EXCEPT:

Loop Diuertics

Thiazide Diuretics

Potassium Sparing Diuretics - Answer Potassium Sparing Diuretics

DRUG:Spironolactone - is a synthetic steroid that antagonizes aldosterone that is
present at the aldosterone intracellular receptors, which results in a failure to produce
proteins that normally stimulate the Na+/K pump à lack of Na+ Reab & lack K+ Excretion
( K+ sparred)

•ALDACTONE has not been demonstrated to elevate serum uric acid, to precipitate
gout, or to alter carbohydrate metabolism.

The Osmotic Diuretic Mannitol ________________________ Blood Plasma Osmolality, which
enhances flow of water from tissues, including the brain and cerebrospinal fluid, into
interstitial fluid and plasma for eventual excretion.

increases

decreases - Answer increases

•Mannitol -

A.administered IV and elevates blood plasma osmolality, resulting in enhanced flow of
water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and
plasma for excretion via the kidney.

B.It is a pharmacologically inert substance that is freely filtered by the glomeruli of the
kidney, but is incapable of being reabsorbed from the renal tubule, resulting in a
decreased water and sodium reabsorption and increased excretion via its osmotic
effect

•Because osmotic diuretics are used to effect increased water excretion rather than
Na+ excretion, they are not useful for treating conditions in which NA+ retention occurs.

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