NURS 245 Lecture Notes - Lecture 29: Chronic Kidney Disease, Acute Kidney Injury, Secondary Hyperparathyroidism
Document Summary
Q1-which of the following would be the explanation of why urine output increase in renal insufficiency: reabsorption decreases more than filtration decreases. Normal reabsorption is 99% ~178 liters with 2 liter output. Renal insufficiency: polyuria-ex: filtration is 90 cut by half and reabsorption is only 85 l (only 55%). Manifestations-polyuria, dehydration and weight loss, hypotension and shock. Renal failure: sodium and water retention-output decreased drastically a) pathogenesis b) manifestations-weight gain, venous distention, congestive heart failure, systemic and pulmonary edema. Pathogenesis-initially they are not reabsorbing potassium in the proximal convoluted tubule b) Manifestations-decreased excitability skeletal muscle weakness, atrophy, paralysis and difficulty breathing; gi tract: paralytic ileus, distention; cardiac arrhythmias. Pathogenesis-can"t filter the potassium to unload it b) Renal failure: metabolic acidosis-because they aren"t reabsorbing sodium bicarbonate and excreting hydrogen ion. Hyperventilation, exchange hydrogen of intracellular potassium, mobilization of calcium phosphate from the bone. Precipitation of acute metabolic acidosis-hypokalemia (if renal failure then hyperkalemia)
