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Renal & Urinary Tract Disorders
Transcript of Renal & Urinary Tract Disorders
Are you confused?
Lets get some clarity!!
The Kidneys & Kidney Disease
Failing Kidneys &
Different types of Dialysis
Make sure you took notes & bring to class!!!
Let's get started!!
Judith Turpen, MSN, APRN, FNP-BC
6L of cardiac output = 60 ml of urine per hour
5L of cardiac output = 50 ml of urine per hour
4L of cardiac output = 40 ml of urine per hour
3L of cardiac output = 30 ml of urine per hour
1L of cardiac output = 30 ml of urine per hour
0L of cardiac output = 0 ml of urine per hour
Anything that affects cardiac output affects the kidney; for ex., heart disease.
Acidic vs alkaline diet
How does it work?
Lab considertions and risk
The Road to Nursing School Success
Goal 1 - NURA 1500
Maintain blood volume & pressure
Fluid & Electrolyte and pH balance
Elimination of waste products
Functional unit or "worker bee - works day and night to get rid of waste in the blood.
1 million tiny filtering units per kidney
Each consist of glomerulus & 4 renal tubules
Let's break down it down to better understand the functions of the urinary system
Urine storage & elimination
Regulates blood pressure
Stimulate erythropoietin (RBC production)
Activation of calcium & vitamin D
20-25% blood flow from heart perfuse the kidneys
What does renin do?
Normal 7.35 - 7. 45
Buffer system - mixture of weak acid & weak base which resist changes in pH.
3 buffers: Bicarbonate, phosphate, protein
Ventilation deph & speed in lungs
H+ secretion in kidneys (most effective but very slow.
There is a direct relationship between cardiac output and renal output
System Specific Physiology
Function of Nephron
Remove excess water, wasters and other substances from your blood.
Return substances like sodium, potassium, or phosphorus whenever any of these substances run low in your body.
Glomerulus responsible for cleansing of the blood - acts as a filter by osmosis and diffusion
The previous diagram is from your book; let's simplify for your understanding. Advance to the next slide.
RAAS = Renin Angiotension Aldosterone System
Click on the arrows at the bottom of the presentation to advance through the slides. I have included videos for you to view on several renal system topics. The vidoes will start on their own. It is not necessary to click on the video itself. Make notes, we will review briefly in class. I expect full participation.
Thank you and I hope you enjoy!
Function of Kidneys:
Maintain blood volume & pressure
Ensure balance of sodium, chloride, potassium, calcium, hydrogen, phosphate & pH.
Eliminate products of metabolism, such as urea, uric acid & creatinine.
Filtration of blood by glomerulus to form ultra filtrate urine
Reabsorption - of electrolytes & nutients
Secretion of waste materials.
- considered the functional unit of kidney; over 1 million.
where necessary substance reabsorped from bloodstream & unneeded material wasted through urine.
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
What to look smart..write it down and bring to class!!!
Ok, so that did help...let's try again.
decrease blood volume
Renin = vasoconstrict arterioles which increases BP
Aldosterone = increased Na+ which increases BP AND...oops....
One more helpful reminder: where Na is water follows....
Mary had a little lamb, his fleece was white as snow & everywhere that Mary went the lamb was sure to go.
It wasn't that difficult .... right.
Don't forget make your notes so you can be a star in class.
Risk Factors for
Polycystic kidney dz
Family hx kidney dz
Normal GFR 125 ml/min
Stage 5 = End Stage Kidney Disease (ESKD) = Dialysis
Uremia - build up of urea, salts, potassium, & phosphates leads to bone disease and anemia.
Treatment for ESKD
New way to filter & balance
your fluid & electrolytes
- Kidney transplant
Planning starts when GFR = 20 ml/min= 20% kidney function
Symptoms of kidney failure
- decreased appetite
- shortness of breath
Reminders issues seen with Dialysis patients
Kidneys regulate hormone production that stimulates RBC production so will see anemia - low hemoglobin - expect low H/H - may give Epogen
Hold medications prior to HD
Prior HD - expect elevated K+, BUN, Creat
Catheter inserted through abdominal wall
Risk: infection -observe for redenss, tenderness & exudate
Peritonitis - observe for cloudy return of dialysate
Send cloudy fluid for culture
Weight is best gauge of fluid removal
Assess lung sounds for fluid overload.