NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
Assessment
Each kidney has a million nephrons. One kidney can be donated. You can
live with only one functioning kidney.
-Filters the blood and gets rid of waste products and electrolytes and water
if too much. (Potassium, creatinine, urea, nitrogen, uric acid, surfer- waste
product of proteins)
-Produces erythropoietin (stimulates the bone marrow to make RBC).
Kidney problems can lead to anemia (Patient might need an erythropoietin
stimulator)
-Gets rid of unwanted water
-Activates vitamin D, which is needed to activate calcium. (Osteoporosis,
osteomalacia can occur).
-Renal artery(septal glomerulus apparatus which secretes renin). If there is
not enough blood volume, renin will be secreted. Renin in the blood vessel
stimulates the liver to secrete angiotensinogen to become angiotensin 1.
Angiotensin 1 travels to the lungs, and it becomes angiotensin 2.
Vasoconstriction occurs, and it increases blood pressure
-Hypothalamus stimulates the anterior pituitary gland to secrete ACTH,
which stimulates the adrenal cortex to release aldosterone. High levels of
aldosterone
-Sodium and water increase in the blood
-Kidney maintains PH balance-homeostasis(reabsorbs bicarbonate from the
urine back to the blood and secrete hydrogen ions into the urine.
-Kidney produces prostaglandin (linked to inflammation) when there is not
enough fluid in the kidney. Causes dilation
Subjective data:
-Fatigue, lethargy due to waste products going into the brain
-Anorexia, nausea, weight gain, edema
-Pruritus, nocturia, headache
-Costovertebral angle tenderness
Objective data:
-Hyperkalemia (due to tissue damage)
-Elevated creatinine during kidney damaged
-Elevated BUN
-Hyponatremia due to hemodilution, diuretics increase sodium levels
-Skin color can be a little yellow due to urea building up in the
subcutaneous tissue (Sallow)
-Hypertension due to renal vascular constriction, which causes elevated
,NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
afterload, and left ventricular failure. Renal injury can also cause renal
vascular constriction causing hypertension.
,NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
One glomerulus contains a bowman capsule and a tubule
Blood comes from the left ventricle into the afferent blood vessel and then
is removed (stroke volume 80) (CO is 6000/minute)
Glomerular blood hydrostatic pressure (55 mmHg) filtration is based on
cardiac output pressure. The glomerulus has capsular hydrostatic pressure
(15mmHg) and blood colloid osmotic pressure(holds onto water, 30 mmHg)
inside. The glomerular blood hydrostatic pressure must be high enough in
order to overcome the other two. If there is not enough pressure, the patient
will have no urine output. When net pressure is minus, there is no urine
output.
There is continuous communication between the tubule and the blood vessel
Proximal tubule: electrolytes and waste products are leaking out and are
reabsorbed into the blood vessel
Henle loop: there is a higher pressure which causes
reabsorption Distal tubule: secretion of electrolytes and
final reabsorption
Collecting duct: by the time fluid gets here, there is no reabsorption,
only excretion High levels of urea, ammonia, nitrogen, uric acid waste
products.
Costovertebral angle, T12 (last rib)If a patient complains of pain during
percussion, kidney problems are suspected.
When there is congestive heart failure, CVP is high and ANP, BNP is
elevated (when the right ventricle is stretched, the ANP enzyme is
released (the more ANP, the more vasodilation, which causes a drop in
blood pressure. Renin production is decreased, Ang II and I, aldosterone is
also decreased. GFR increases, natriuresis occurs (elimination of water)
which leads to a decreased blood volume, CO, CVP, SVR. The
prostaglandin being produced also causes more dilation in the vessels in
the kidney.
Diagnostics
-Urinalysis
WBC in the urine (infection, SIRS,
sepsis) RBC in urine (bleeding)
Bilirubin is the urine (jaundice, liver problem, gallbladder, pancreas
, NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
problem)
-BUN: waste product from the protein. Gets excreted
through urine Normal is 5-20
High kidney problems, severely dehydrated, bleeding
GRADED A+ 2022/2023 UPDATE
Assessment
Each kidney has a million nephrons. One kidney can be donated. You can
live with only one functioning kidney.
-Filters the blood and gets rid of waste products and electrolytes and water
if too much. (Potassium, creatinine, urea, nitrogen, uric acid, surfer- waste
product of proteins)
-Produces erythropoietin (stimulates the bone marrow to make RBC).
Kidney problems can lead to anemia (Patient might need an erythropoietin
stimulator)
-Gets rid of unwanted water
-Activates vitamin D, which is needed to activate calcium. (Osteoporosis,
osteomalacia can occur).
-Renal artery(septal glomerulus apparatus which secretes renin). If there is
not enough blood volume, renin will be secreted. Renin in the blood vessel
stimulates the liver to secrete angiotensinogen to become angiotensin 1.
Angiotensin 1 travels to the lungs, and it becomes angiotensin 2.
Vasoconstriction occurs, and it increases blood pressure
-Hypothalamus stimulates the anterior pituitary gland to secrete ACTH,
which stimulates the adrenal cortex to release aldosterone. High levels of
aldosterone
-Sodium and water increase in the blood
-Kidney maintains PH balance-homeostasis(reabsorbs bicarbonate from the
urine back to the blood and secrete hydrogen ions into the urine.
-Kidney produces prostaglandin (linked to inflammation) when there is not
enough fluid in the kidney. Causes dilation
Subjective data:
-Fatigue, lethargy due to waste products going into the brain
-Anorexia, nausea, weight gain, edema
-Pruritus, nocturia, headache
-Costovertebral angle tenderness
Objective data:
-Hyperkalemia (due to tissue damage)
-Elevated creatinine during kidney damaged
-Elevated BUN
-Hyponatremia due to hemodilution, diuretics increase sodium levels
-Skin color can be a little yellow due to urea building up in the
subcutaneous tissue (Sallow)
-Hypertension due to renal vascular constriction, which causes elevated
,NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
afterload, and left ventricular failure. Renal injury can also cause renal
vascular constriction causing hypertension.
,NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
One glomerulus contains a bowman capsule and a tubule
Blood comes from the left ventricle into the afferent blood vessel and then
is removed (stroke volume 80) (CO is 6000/minute)
Glomerular blood hydrostatic pressure (55 mmHg) filtration is based on
cardiac output pressure. The glomerulus has capsular hydrostatic pressure
(15mmHg) and blood colloid osmotic pressure(holds onto water, 30 mmHg)
inside. The glomerular blood hydrostatic pressure must be high enough in
order to overcome the other two. If there is not enough pressure, the patient
will have no urine output. When net pressure is minus, there is no urine
output.
There is continuous communication between the tubule and the blood vessel
Proximal tubule: electrolytes and waste products are leaking out and are
reabsorbed into the blood vessel
Henle loop: there is a higher pressure which causes
reabsorption Distal tubule: secretion of electrolytes and
final reabsorption
Collecting duct: by the time fluid gets here, there is no reabsorption,
only excretion High levels of urea, ammonia, nitrogen, uric acid waste
products.
Costovertebral angle, T12 (last rib)If a patient complains of pain during
percussion, kidney problems are suspected.
When there is congestive heart failure, CVP is high and ANP, BNP is
elevated (when the right ventricle is stretched, the ANP enzyme is
released (the more ANP, the more vasodilation, which causes a drop in
blood pressure. Renin production is decreased, Ang II and I, aldosterone is
also decreased. GFR increases, natriuresis occurs (elimination of water)
which leads to a decreased blood volume, CO, CVP, SVR. The
prostaglandin being produced also causes more dilation in the vessels in
the kidney.
Diagnostics
-Urinalysis
WBC in the urine (infection, SIRS,
sepsis) RBC in urine (bleeding)
Bilirubin is the urine (jaundice, liver problem, gallbladder, pancreas
, NURS 411EXAM NURSING RENAL NOTES
GRADED A+ 2022/2023 UPDATE
problem)
-BUN: waste product from the protein. Gets excreted
through urine Normal is 5-20
High kidney problems, severely dehydrated, bleeding
