Homeostasis of a kidney (Regulates Blood Composition and Waste Removal…
Homeostasis of a kidney
Regulates Bone Marrow Production
The kidney promotes bone fracture and healing by producing erythropoietin. Erythropoietin is a 30.4kD glycoprotein and class 1 cytokine that is unique by its role in the regulating the production of red blood cells in the bone marrow.
Inadequate Production of Red Blood Cells by the Bone Marrow Will Result in Anemia
is a condition in which you lack enough healthy red blood cells to carry adequate oxygen oxygen to your body's tissues.
Signs and symptoms; Headache, fatigue, weakness, decreased mental status
Heart Problems- arrhythmia, tachycardia, SOB upon exersion
: decreased hemoglobin in blood cells and deminished oxygen-carrying capacity of the blood as evidence by increased rest requirements, report of fatigue and lack of energy, inability to maintain usual level of physical activity, and discomfort or dyspnea
Assist the client in planning and prioritizing activities of daily living (ADL).
This will allow the client to maximize his/her time for accomplishing important activities. Not all self-care and hygiene activities need to be completed i the morning. Likewise, not all housework needs to be completed in one day
Assist the client in developing a schedule for daily activity and rest. Stress the importance of frequent rest periods.
Energy reserves may be depleted unless the client respects the body’s need for increased rest. A plan that balances periods of activity with periods of rest can help the client complete desired activities without adding levels to fatigue.
Educate energy-conservation techniques
Clients and caregivers may need to learn skills for delegating task to others, setting priorities, and clustering care to use available energy to complete desired activities. Organization and time management can help the client conserve energy and reduce fatigue
Regulates Blood PH
The kidneys can regulate reabsorption of carbonic acid in the tubule, increasing or reducing acid secretion. So, urine that is more acidic than normal may mean the body is ridding itself of excess dietary acid and thus making blood pH more alkaline.
Loss of regulation leads to metabolic acidosis:
An excess of acid (hydrogen ions) and a lack of base (bicarbonate) stemming from an overproduction of acid, loss of intestinal bicarbonate, inefficient conservation of bicarbonate, and excretion of acid.
headache, drowsiness, fatigue, weakness, increased respiratory rate and depth, nausea and vomiting, diminished cardiac output with pH below 7, which results in hypotension, cold clammy skin and cardiac arrhythmias.
Nursing Dx: lethargy, fatigue, and muscle weakness
Keep sodium bicarbonate ampules handy for emergency administration.
Monitor vital signs, laboratory results and level of consciousness frequently.
Evaluation and correction of electrolyte imbalances and ultimately correction and management of the underlying cause.
Watch out for signs of decreasing level of consciousness.
Administration of sodium bicarbonate I.V. for severe cases
For management of vomiting (common to metabolic acidosis), position the patient to prevent aspiration.
Record intake and output accurately to monitor renal function.
Provide good oral hygiene after incidences of vomiting. Use sodium bicarbonate washes to neutralize acid in the patient’s mouth.
Prepare for possible seizures and administer appropriate precautions.
Regulates Blood Composition and Waste Removal
Your kidneys play a vital role in keeping your blood composition constant. They filter your blood to remove excess water and waste products, which are secreted from your kidneys as urine. One quarter of your blood supply passes through your kidneys every minute.
Loss of Function may lead to Azotemia & Ureamia
Monitor Serum Electrolytes level.
Monitor I &O
Check BUN & Crea level
Regulates H2O Balance
One way the the kidneys can directly control the volume of bodily fluids is by the amount of water excreted in the urine. Either the kidneys can conserve water by producing urine that is concentrated relative to plasma, or they can rid the body of excess water by producing urine that is dilute relative to plasma.
compromised regulatory mechanism may result to excess fluid volume
Risk for electrolytes imbalance.
The signs of hypervolemia include: swelling, also called edema, most often in the feet, ankles, wrists, and face. discomfort in the body, causing cramping, headache, and stomach bloating. high blood pressure caused by excess fluid in the bloodstream
Regulates Blood Pressure
The kidney plays a central role in the regulation of arterial blood pressure. ... Renal artery perfusion pressure directly regulates sodium excretion-a process known as pressure natriuresis-and influences the activity of various vasoactive systems such as the renin-angiotensin-aldosterone system.
Loss of blood pressure control may result to Hypertension.
Nuring DX: Inadequate blood pumped by the heart to meet metabolic demands of the body.
Check laboratory data (cardiac markers, complete blood cell count, electrolytes, ABGs, blood urea nitrogen and creatinine, cardiac enzymes, and cultures, such as blood, wound or secretions).
Monitor and record BP. Measure in both arms and thighs three times, 3–5 min apart while patient is at rest, then sitting, then standing for initial evaluation. Use correct cuff size and accurate technique.
ACE Inhibitors; ARBS
The kidneys help maintain electrolyte concentrations by filtering electrolytes and water from blood, returning some to the blood, and excreting any excess into the urine.
LOSS OF THIS FUNCTION LEADS TO: ELECTROLYTE IMBALANCE
Calcium- The body moves calcium out of bones into the blood to maintain calcium levels. PTH increases the calcium level in blood whereas calcitonin is responsible for lowering calcium level in the blood. Too much calcium is Hypercalcemia and too little calcium is Hypocalcemia.
Hypocalcemia: numbness and/or tingling of the hands, feet, or lips, muscle cramps, muscle spasms, seizures, facial twitching, muscle weakness, lightheadedness, and. slow heartbeat.
Diagnosis: Imbalanced nutrition
Intervention: maintain IV access, high calcium diet, monitor intake and output
Hypercalcemia: Excessive thirst and frequent urination, stomach pain and digestive problems, bone pain and muscle weakness, confusion, lethargy, and fatigue, anxiety and depression, high blood pressure and abnormal heart rhythms.
Phosphorus-Imbalances in phosphate may be too high (Hyperphosphatemia) or too low (Hypophosphatemia).
Hyperphosphatemia- muscle cramps, tetany, and perioral numbness or tingling. Other symptoms include bone and joint pain, pruritus, and rash
-changes to diet and medication to treat hyperphosphatemia. and dialysis
Hypophosphatemia- muscle weakness, fatigue, bone pain, bone fractures, appetite loss, irritability, numbness, confusion, and slowed growth and shorter than normal height in children
Potassium - Imbalances in potassium can lead to high potassium (Hyperkalemia) or low potassium (Hypokalemia).
Hyperkalemia- muscle weakness, fatigue, nausea, muscle pain or cramps, difficulty breathing, and unusual heart beat and chest pain.
Diagnosis: -decreased cardiac output
-risk for imbalanced fluid volume -activity intolerance
intervention: administer IV insulin and glucose to move potassium from extracellular fluid to intracellular fluid,
-give diuretics to remove potassium from body, avoid foods high in potassium
Hypokalemia- weakness and fatigue, muscle cramps and spasms, digestive problems, heart palpitations, muscle aches and stiffness, tingling and numbness, breathing difficulties, and mood changes
Sodium- When sodium intake and excretion are not in balance, it may lead to either high sodium (Hypernatremia) or low sodium (Hyponatremia).
hyponatremia- Nausea and vomiting, headache, vomiting, fatigue, restlessness and irritability, Muscle weakness, spasms or cramps, seizures, or coma
Hypernatremia-- excessive thirst, lethargy, muscle twitching or spasms, With severe elevations of sodium, seizures and coma may occur.