1
Study Guide Exam 3
NSG 530 / NSG 530
EXAM 3 STUDY GUIDE
Advanced Pathophysiology – Wilkes
THIS GUIDE CONTAINS:
tailored to advanced practice nursing students
at Wilkes University.
Focusing on key concepts
is organized for clarity and comprehensive review.
Expert-Verified
,2
Study Guide Exam 3
Urine Formation
Filtration GF first step in urine formation—permeable substances
in blood are filtered at the endothelial-capsular membrane into
Bowman Capsule.
Reabsorption Tubular reabsorption retain substance needed
substances are reabsorbed and returned to the blood.
Secretion Tublar secretion excretes chemicals not needed by the
body (hydrogen, amino acids, urea, creatinine, some drugs).
*Anuria- <100ml /day
*Oliguria <400ml/day
Urea – byproduct of protein
Creatinine- byproduct of
muscle
Renal Hormones
Renin—BP regulation
*HTN—patient’s usually have an underlying renal issue.
Erythropoietin—Erythrocyte production
*Renal issues can cause anemia.
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Study Guide Exam 3
D3—Calcium metabolism (calcium
reabsorption) Calcium will begin to
decrease.
Calcium and Phosphorus have an inverse relationship. So,
phosphorus will be elevated in renal issues.
Severe Fasting—kidneys can synthesize glucose. The brain is
totally dependent upon glucose.
Urine Function Tests—Urinalysis and BUN & Creatinine.
BUN—measures the concentration of urea in the blood. Urea is
formed by protein metabolism and is elevated I reduced
glomerular filtration. Normal BUN is 10-20 mg/dl.
- BUN rises in states of dehydration and in states of Acute
and Chronic renal failure because passage of fluid through
the tubules is slow.
Serum Creatinine— more constant value than BUN. Creatinine is
a by-product of muscle metabolism, and its level of production
are constant and proportional to the mass. Not reabsorbed.
Normal level 0.7-1.2 mg/dl.
- Increased levels represents decreasing glomerular filtration
rate.
- If doubled, renal function if cut in ½.
- If tripled, 75% renal function is lost.
Creatinine Clearance- the amount cleared by kidney 1 minutes
of filtration 90-130 ml/min is normal.
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Study Guide Exam 3
Urinalysis—it is normal to have inorganic material such as Na+, Cl-
, and K+. Organic materials such as Urea/Creatinine.
- It is abnormal to have RBCs, WBCs, Bacteria, Protein,
Glucose, or Ketones
Kidney disorders/urologic
Urinary Tract Obstruction an interference with the flow of urine
at any site along the urinary tract. Can be anatomic or functional.
Kidneys begin to swell= Hydronephrosis decreased GFR
increased hydrostatic pressure in the Bowman’s capsule (from
urine backflowing) = Filtration will NOT occur.
Compensatory hypertrophy.
Kidney Stones Calculi or urinary stones. Are masses of crystals,
protein, or other substances that form within & obstruct the
urinary tract. Causing flank PAIN. Classified— minerals
comprising stones. Formed by: supersaturation of one or more
salts, (i.e Paget’s Disease bone releases too much calcium into
the blood stream), precipitation of a salt from a liquid solid,
crystallization or aggregation. Renal colic intermittent pain.
Calcium oxalate or calcium phosphate (most common- 80-85%)—
calcium binds with oxalate and makes calcium precipitate. We
will manipulate oxalate to prevent calcium stones.
Struvite stones—patient with
UTI. Uric Acid Stones—patient
with gout.
Study Guide Exam 3
NSG 530 / NSG 530
EXAM 3 STUDY GUIDE
Advanced Pathophysiology – Wilkes
THIS GUIDE CONTAINS:
tailored to advanced practice nursing students
at Wilkes University.
Focusing on key concepts
is organized for clarity and comprehensive review.
Expert-Verified
,2
Study Guide Exam 3
Urine Formation
Filtration GF first step in urine formation—permeable substances
in blood are filtered at the endothelial-capsular membrane into
Bowman Capsule.
Reabsorption Tubular reabsorption retain substance needed
substances are reabsorbed and returned to the blood.
Secretion Tublar secretion excretes chemicals not needed by the
body (hydrogen, amino acids, urea, creatinine, some drugs).
*Anuria- <100ml /day
*Oliguria <400ml/day
Urea – byproduct of protein
Creatinine- byproduct of
muscle
Renal Hormones
Renin—BP regulation
*HTN—patient’s usually have an underlying renal issue.
Erythropoietin—Erythrocyte production
*Renal issues can cause anemia.
,3
Study Guide Exam 3
D3—Calcium metabolism (calcium
reabsorption) Calcium will begin to
decrease.
Calcium and Phosphorus have an inverse relationship. So,
phosphorus will be elevated in renal issues.
Severe Fasting—kidneys can synthesize glucose. The brain is
totally dependent upon glucose.
Urine Function Tests—Urinalysis and BUN & Creatinine.
BUN—measures the concentration of urea in the blood. Urea is
formed by protein metabolism and is elevated I reduced
glomerular filtration. Normal BUN is 10-20 mg/dl.
- BUN rises in states of dehydration and in states of Acute
and Chronic renal failure because passage of fluid through
the tubules is slow.
Serum Creatinine— more constant value than BUN. Creatinine is
a by-product of muscle metabolism, and its level of production
are constant and proportional to the mass. Not reabsorbed.
Normal level 0.7-1.2 mg/dl.
- Increased levels represents decreasing glomerular filtration
rate.
- If doubled, renal function if cut in ½.
- If tripled, 75% renal function is lost.
Creatinine Clearance- the amount cleared by kidney 1 minutes
of filtration 90-130 ml/min is normal.
, 4
Study Guide Exam 3
Urinalysis—it is normal to have inorganic material such as Na+, Cl-
, and K+. Organic materials such as Urea/Creatinine.
- It is abnormal to have RBCs, WBCs, Bacteria, Protein,
Glucose, or Ketones
Kidney disorders/urologic
Urinary Tract Obstruction an interference with the flow of urine
at any site along the urinary tract. Can be anatomic or functional.
Kidneys begin to swell= Hydronephrosis decreased GFR
increased hydrostatic pressure in the Bowman’s capsule (from
urine backflowing) = Filtration will NOT occur.
Compensatory hypertrophy.
Kidney Stones Calculi or urinary stones. Are masses of crystals,
protein, or other substances that form within & obstruct the
urinary tract. Causing flank PAIN. Classified— minerals
comprising stones. Formed by: supersaturation of one or more
salts, (i.e Paget’s Disease bone releases too much calcium into
the blood stream), precipitation of a salt from a liquid solid,
crystallization or aggregation. Renal colic intermittent pain.
Calcium oxalate or calcium phosphate (most common- 80-85%)—
calcium binds with oxalate and makes calcium precipitate. We
will manipulate oxalate to prevent calcium stones.
Struvite stones—patient with
UTI. Uric Acid Stones—patient
with gout.
