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Module 9

Kidney and Urinary Tract Function

Sasha Wright, RN, BSN

Monday, March 21st, 2022

University of West Florida

NGR 6140: Advanced Pathophysiology

Dr. Angela Blackburn

Video Presented Case Study

Case Study

A 56-year-old woman presents to you today complaining of urinary frequency, urgency, and dysuria. She reports that her urine is cloudy and smells abnormal.

She has a diagnosis of diabetes type II and hypertension. As a healthcare provider, you know this patient is at risk for chronic kidney disease (CKD) related to her diagnoses of diabetes type II and hypertension.

Kidneys & Blood Pressure Regulation

  • reabsorbs H2O (water), HCO3 (bicarbonate), sodium (salt), glucose (sugar) chloride, amino acids, and magnesium (p. 842)

  • secretes products such as hydrogen, potassium, and acid/bases (p. 834 & 847)

  • hydrostatic pressure system to ultrafiltrate waste (p. 846)

  • RAA mechanisms

Kidney & Blood Pressure

Regulation

  • Renin-Angiotension-Aldosterone (RAA) Mechanisms (p. 853-855)

1. Explain how the kidneys play a central role in blood pressure regulation.

Renin-Angiotensin-Aldosterone (RAA) Mechanisms (p. 853-855)

Leukocyte Esterase Test & Nitrite Test

  • chemical urine analysis

  • reveals infection in urine

  • Leukocyte Esterase test detects leukocytes/white blood cells in the urine (p. 857)

  • Nitrite test detects bacteria in the urine (p. 857)

Leukocyte Esterase Test & Nitrite Test

2. Explain the basis of a leukocyte esterase test and a nitrite test.

Chronic Kidney Diseases (CKD)

Chronic Kidney Disease

Discuss three clinical manifestations of CKD other than cardiovascular disorders.

Gastrointestinal Disorders

(p. 900)

Gastrointestinal

Disorders

  • loss of appetite
  • nausea
  • vomiting
  • anorexia
  • ulcers
  • hiccups
  • uremia

Immune

Dysfunction (p. 901)

Immune Dysfunction

  • uremia
  • low granulocyte count
  • decreased humoral immunity
  • decreased cell-mediated immunity
  • phagocytic dysfunction
  • increased metabolic waste
  • slow response to inflammation and hypersensitive occurrences

Metabolic Disorders r/t Skeletal Disorders

(p. 897)

Metabolic Disorders

  • hypocalcemia
  • vitamin D deficiency
  • hyperparathyroidism
  • bone diseases (i.e. CKD-MBD)

Probable Diagnoses

Probable Diagnoses

1. lower urinary tract infection (UTI) (p. 875)

2. chronic kidney disease (CKD) (p. 918)

Urge incontinence and nocturia are signs of CKD. Long-term damage can cause denervation of the kidneys and hyperexcitability of the bladder due to diabetes mellitus (p. 918).

4. Why would it be important for you, as her healthcare provider, to ask the patient if she has been experiencing nocturia and urge incontinence currently or in the past?

Works Cited

Works Cited

Norris, T.L. (2020). Porth's Essentials of Pathophysiology (5th ed.). Wolters Kluwer.

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