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Lecture

NURS 2090 Lecture Notes - Body Fluid, Polycystic Kidney Disease, Detrusor Urinae Muscle


Department
Nursing
Course Code
NURS 2090
Professor
Heather Helpard

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Altered Elimination
Urinary Elimination
Urine production
Process: excreted via a complex interplay btw neural, motor and hormones
Elimination: needs to be patent!
Renal Processes:
1. Regulation of body fluid volume and composition
2. Elimination of metabolic wastes
3. Synthesis, release and/or activation of hormones
a. Erythropoietin (hormone for red cell production)
b. Renin (converts Angio I to Angio II, stimulating aldosterone secretion)
c. Vitamin D (secreted by kidneys to stimulate calcium absorption in the GI)
4. Regulation of blood pressure (RAAS)
Urine Production:
Nephron: Role is to filter water soluble substances in blood, Reabsorb nutrients, secrete
waste
Renal blood flow makes up 20-25% cardiac output (1000 ml blood/minute)
Urinary filtrate
Enters the Bowman’s capsule through the tubule system
Transport via countercurrent mechanism (vasa recta is a capillary that moves in the
opposite direction of the filtrate in the tubule).
Excreted as urine
Cortex: glucocorticoids Medulla: NE/E

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Substance
Filtration Site
Passive Reabsorption
Active Reabsorption
Sodium
glomerules
Potassium
glomerules
Proximal tubule
Thick ascending loop of Henle
Chloride
glomerules
Late proximal and distal tubule
Proximal tubule, ascending LoH,
distal convoluted tubule
Hydrogen
*secreted actively in
proximal, distal
convoluted and
collecting tublues
Proximal convoluted tubule
Bicarbonate
glomerules
Proximal and distal convoluted
tubule
Glucose
glomerules
Completely reabsorbed by active
mechanisms unless tubular
maximum is exceeded
Urea
glomerules
Proximal, late distal and
collecting duct
Calcium
glomerules
Proximal tubule and thin LoH
Ascending thick LoH and early
distal convoluted tubule
Phosphate
glomerules
Proximal tubule
Magnesium
glomerules
Ascending thick LoH
Ascending thick LoH
Uric Acid
glomerules
Early and late proximal tubule
Protein
glomerules (limited)
Proximal distal tubule by AAs
Urine Removal:
Transport of urine: Ureters are composed of smooth muscle fibers that propel urine to
bladder via peristalsis. (urine enters bladder via the trigone, which serves as a sphincter to
prevent urine from moveing back into the ureter from bladder)
Bladder filling:
Activates stretch receptors
Signal stimulates contraction of detrusor skeletal muscle via parasympathetic
cholinergic motor fibers
Relaxation of internal and external urethral sphincter results in micturition
Spinal cord injury S1-S2: worried about bladder control
Urinary Excretion
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