Philosophy

Admission Lab Work Sodium 135 mEq/L Potassium 3.4 mEq/L Chloride 99 mEq/L BUN 18 mg/dL Creatinine 1.0 mg/dL Hemoglobin 11 g/dL

13. Understand the transportation of potassium and sodium across plasma membranes. (p. 10 bottom right, p. 20 bottom right, p. 21 diagram)

Consequently, the efferent arteriole, which filters blood away from the glomerulus, is tinier in diameter than the afferent arteriole, which carries blood into each glomerulus. This puts blood under high pressure in the glomerulus; thus it forces tiny molecules and liquid out of the capillary and into the Bowman’s capsule. Soon afterwards, the tiny and liquid molecules cross the epithelium of the Bowman’s capsule, the basement membrane and capillary wall in order to get into the Bowman’s capsule and to arrive in the nephron tubules. The consequence of this is that the filtrate (the tiny and liquid molecules) pass along the remainder of the nephron and helpful substances are reabsorbed along the route. Last of all, “the filtrate flows through the collecting duct and passes out of the kidney along the ureter” as mentioned by (Parson’s, R: p128).

This is when the water molecules come from a higher concentration within the body and they then transfer into a region of low concentration, this happens through the partially permeable membranes within the

Differentiate between the causes, signs and symptoms, and diagnostic findings in pre- renal, intra-renal, and post-renal failure.

the renal issues began. One of the function of the kidneys is to regulate blood volume and pressure.

His vital signs are as follows: BP 172/100, heart rate 92 beats per minute, and a temperature of 102.2 F. There have been some labs done. His red blood count is 3.1 million cells, white blood count is 22,000 cells, potassium is 5.4 mEq/L, calcium is 6.8 mg/dL, phosphate is 4.3 mEq/L, urea is 37 mg/dL, creatinine 2.0 mg/dL, albumin is 2.9 mg/dL, and pH is 7.29. With labs like these, more testing was done. A chemistry panel which showed protein 1.7

10. What structural modification of certain tubule cells enhances their ability to reabsorb substances from the filtrate?

In patients with renal failure the two most common electrolyte abnormalities are hyperkalemia and hypermagnesemia. Hyperkalemia results due to decreased renal excretion resulting from renal failure. Both of these abnormalities are initially treated with IV calcium gluconate if the patients are symptomatic. The calcium is given to antagonize the effects of hyperkalemia and hypermagnesemia. The calcium acts to protect the heart muscle temporarily until other treatments can be administered. It is imperative to monitor the patient closely with and ECG when IV calcium is administered due to calcium induced

The drug that do not enter the glomerular filtrate leaves the glomeruli though efferent arterioles. The arterioles divide to form a capillary plexus surrounding the nephric lumen in the proximal tubule. The occurrence of secretions mainly occurs in the proximal tubule. This happens by active transport, one for anions and one for cations. Active transport requires energy. The two systems have low specificity and can transport many compounds. [2]

The amount of glucose detected in the urine was 500 mg/d, measuring above the norm of 130-180 mg/d. A high glucose concentration could be associated with calcium oxalate and calcium phosphate. High levels of glucose may occur with diabetes, renal glycosuria, and pregnancy. A follow-up test for diabetes may be given for these reasons. There was a small indication of bilirubin in the urine sample which should normally pass into the liver. Presence of bilirubin cold indicate live damage or diseases such as hepatitis. No ketones were found in the urine we sampled which is normal. The specific gravity of the urine reflects the patient’s hydration status and the sample measured a normal 1.030. In the urine sample there was a trace amount of blood found. This could require additional resting for a sign of kidney damage or infection, kidney or bladder stones or cancer, and blood disorders. Blood also creates a change in the color of urine, perhaps this had something to do with the abnormal coloring of the urine sample. The PH and urobilinogen were both identified as normal by the test. A trace amount leukocytes were identified in the urine. A small amount of leukocytes are normal and expelled in the urine when they are damaged or killed when fighting an infection. A high number of leukocytes may show signs of infection in the urinary system and create cloudy and foul smelling urine. A positive

In addition, DEX exposure may contribute to renal apoptosis and impaired expression of genes involved in nephrogenesis leading to reduced nephron number (Tain et al., 2014). On the other hand, sodium transport regulation in the kidney is important to maintain the regulation of extracellular fluid volume and arterial blood-pressure (Knepper and Brooks, 2001). Some studies showed that DEX-induced programmed hypertension can be the result of alteration in the kidney transporters including increase in the protein expression of type 3 Na+/H+ exchanger (NHE3), Na+-K+-2Cl− cotransporter (NKCC2), and Na+-Cl− cotransporter (NCC). The upregulation of two critical renal Na transporters Na-K-2Cl and Na-Cl in prenatally programmed hypertension suggested that increased Na+ reabsorption in thick ascending limb and distal convoluted tubule plays an important role in the development of hypertension (Manning et al.,

Increase in serum creatinine (SCr) by > 0.3 mg/dl (> 26.5 µmol/l) within 48 hours. OR

Mr. Armstrong has a history of renal insufficiency and uncontrolled hypertension, along with symptoms of fatigue, pedal edema, and occasional shortness of breath. He does not have a history of trauma or obstruction to his kidneys, but his creatinine and BUN levels are currently at 3.5 mg/dl and 40 mg/dl. Normal creatinine concentration values are 0.7 to 1.2 mg/dl and normal BUN values are 10 to 20 mg/dl; this reveals that Mr. Armstrong’s kidneys are not removing wastes properly (McCance, Huether, Brashers, & Rote, 2014).  Mr. Armstrong’s history of renal insufficiency and uncontrolled hypertension is commonly found in patients diagnosed with intrarenal (intrinsic) acute renal failure. Intrarenal acute renal failure can be categorized as

The next assessment would consist of biochemical parameters, which are laboratory tests. The lab tests that Josephine participated in include albumin, sodium, potassium, iron and vitamin B12. Her results show a decreased value in albumin, sodium, iron and vitamin B12. Albumin is a test that provides the measurement of visceral protein stores in the body. Low albumin levels can be caused by malnutrition caused by difficulty absorbing and digesting protein. These types of issues are usually signs of Crohn’s disease or Celiac disease. A sodium test is used to determine if the body is experiencing abnormal levels of sodium. Being a salsa instructor, Josephine needs to stay hydrated, meaning she would increase her intake of water during her time of exercise whether it be during a dance class or in the gym.