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A female elderly patient diagnosed with osteoporosis, chronic type II…
A female elderly patient diagnosed with osteoporosis, chronic type II diabetes mellitus, and high blood
pressure. She noticed blood in her urine which might be the effect of having high blood pressure on her kidney.
Background Information
Anatomy
Kidney
Internal Structure
Renal Cortex
The outer layer; it is made of renal corpuscles and convoluted tubules.
Renal Medulla
The inner tissue layer; it is made of loops of Henle and collecting tubules
Renal Pelvis (Sinus)
A cavity on the medial side of the kidney; it empties urine into the urethra
The nephron
The functional unit of kidney
Uretus
The wall of ureter consists of a smooth muscle layer
Urinary Bladder
located in the pelvic cavity behind the pubic bones
Urethra
Female
The urethra is about 4 cm long and anterior to the vagina
Male
The urethra is about 20 cm long and extends from the bladder through the prostate gland to the tip of the penis
Physiology
Formation of Urine
Renal fitration
takes place from the glomerulus to Bowman's capsule
Blood pressure in the glomerulus forces plasma, dissolved material and small protein out of the blood
Tubular reabsorption
takes place from the filtrate in the renal tubules to the blood in the peritubular capillaries.
Useful materials are returned to the blood by active transport such as glucose, amino acids, positive ions
Tubular secretion
Takes place from the blood in the peritubular capillaries to the filtrate in the renal tubule.
Nitrogen waste product such as creatinine and ammonia may be actively secreted, as are the metabolic products of medications.
Acid/Base Regulation
The body fluids tend to be more acidic with normal metabolism.
The kidneys have the greatest capacity to counteract pH imbalance.
The kidney can excrete H ions if the blood pH is too low or conserve H ions if the blood pH is rising
The nephron
Filtration
Filtration occurs in the glomerulus and is largely passive
About one-fifth of the plasma is filtered as the blood passes through the glomerular capillaries; four-fifths continues into the peritubular capillaries
Normally the only components of the blood that are not filtered into Bowman's capsule are blood proteins, red blood cells, white blood cells and platelets.
Over 150 liters of fluid enter the glomeruli of an adult every day: 99% of the water in that filtrate is reabsorbed
Reabsorption
Reabsorption occurs in the renal tubules and is either passive, due to diffusion, or active, due to pumping against a concentration gradient
Substances reabsorbed include: water, sodium chloride, glucose, amino acids, lactate, magnesium, calcium phosphate, uric acid, and bicarbonate
Secretion
Secretion occurs in the tubules and is active
Substances secreted include urea, creatinine, potassium, hydrogen, and uric acid.
Excretion
Unuseful products will be excreted out of the body
Diseases that caused by kidney dysfunction
Hypertensive heart disease
Symptoms
no signs or symptoms
Causes
A diet high in salt, fat and cholesterol
Lack of physical activity.
Stress.
Tobacco use
drinking too much alcohol
Osteoporosis
Sysptoms
Back pain
A stooped posture
Causes
Hormone levels
Thyroid problems
Low calcium intake
Eating disorders
Steroids and other medications
Type II diabetes
Symptoms
Frequent urination
increased thirst
Causes
the body becomes resistant to insulin
pancreas is unable to produce enough insulin
being overweight and inactive
Effects
High sodium in blood
High blood pressure
Become dehydrated when too much salt in body
Osteoporosis
Causes
Poor diet
Lack of water
High consumption of sodium
Obesity