\u00a0<\/span><\/p>\nNephrotic syndrome, on the other hand, is due to changes to the glomerulus of the nephron that causes leakage of massive protein greater than 3 grams (Proteinuria)\u202fin the urine, hyperlipidemia, hypoalbuminemia, foamy frothy urine dark yellow in color,\u202f generalized edema that start around the eyes and spreads to\u202f other systems of the body.<\/span>\u00a0<\/span><\/p>\n\u202fThe filtrating system in the glomerulus is faulty in nephrotic syndrome they are bigger than their regular size and allows proteins to pass through. In acute glomerulonephritis there is presence of protein but not to compare to the protein loss in the Nephrotic syndrome.<\/span>\u00a0<\/span><\/p>\nThis week\u2019s reading covers changes in the body that affect normal renal functioning. Two specific points of focus are functional and anatomical urinary obstructions. Causations mentioned in the text are urinary calculi (kidney stones) and strictures within the urinary tract. Common causes of renal calculi are consistent dehydration and consuming too much salt. What are some other possible causes of renal calculi? A medical stricture is the narrowing of a body passage, such as a tube or a canal. For example, \u202fscar tissue or a tumor may obstruct the\u202fureter. What are some congenital strictures that affect the kidney and disrupt the normal flow of urine or result in renal dysfunction?<\/span>\u00a0<\/span><\/p>\nFirst, I would like to wish everyone good luck on the mid-term, it is much material to study, but we can do it. In week four readings I learned about the function of the renal system and the different disorders that can affect our body. I didn\u2019t realize that ureter stricture is so prevalent in men until I started working in the hospital.\u202f Restraints within the urinary tract may create an anatomical obstruction. It looks like it is a simple problem. However, these men need to undergo surgery and many times the surgeon will take tissue from the buccal mucosa and put in on the penis as a graft.<\/span><\/p>\nAccording to (McCance, 2013) A urethral stricture is a narrowing of its lumen. It occurs when infection, injury, or surgical manipulation produces a scar that reduces the caliber of the urethra. Most urethral strictures occur in men. Urinary tract infection is common in male and female. Female are more susceptible to having a UTI because of the urethral tract and the fact that our vaginal and anal anatomy is closely related. In the lesson it said that sexually active female and pregnant women are at higher risk to develop UTI, I Can relate to that findings.\u202f<\/span>\u00a0<\/span><\/p>\nMcCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013).\u202f<\/span>Pathophysiology: The biologic basis for disease in adults and children<\/span><\/i>\u202f(7th ed.). St. Louis, MO: Mosby.<\/span>\u00a0<\/span><\/p>\nWK 4 Open Forum<\/span>\u00a0<\/span><\/h3>\nThis week\u2019s reading material is focused on the pathophysiology and alterations of the renal and urologic systems. Both organ systems according to our textbook and knowledge ascertained throughout the years working not only psychiatric, but other medical disciplines. That we care for patients during vulnerabilities secondary to acute exacerbations of medical comorbidities. \u202fOur textbook References the importance of both organs and appendages in maintaining homeostasis the body. Through the regulation of fluid volume and the removal of toxins and excess waste. <\/span><\/p>\nOver the years in the medical discipline, one the principles that remained a constant in my mind that was learned from nursing school, was the need to discontinue the medication Glucophage also known as metformin. At least 48 hours before a patient would be administered radiocontrast media. The generalized understanding was that the pharmacokinetics of the contrast media and Glucophage would lead to a potential toxic level of lactic acid which could progress to lactic acidosis. As a result of the material used in this week\u2019s lesson, the writer learned another fundamental principle.<\/span><\/p>\n Which consists of factors that contribute to ischemic acute tubular necrosis (ATN). One of the primary causes of intrarenal acute kidney injury secondary to ischemia have been closely associated with significant exposure to \u201cantibiotics and radio contrast media\u201d and medical conditions such as \u201cglomerulonephritis, disseminated intravascular coagulation (DIC), vascular disease and malignant hypertension\u201d (McCance, Huether, Brashers, & Rote, 2014, p. 1360).<\/span>\u00a0<\/span><\/p>\nReferences<\/span>\u00a0<\/span><\/h3>\nMcCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2014). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, Missouri: Mosby<\/span>\u00a0<\/span><\/p>\nThis week has provided information on the renal system. The renal system plays an important role in our body as it filters and excretes unwanted ion, chemicals, and excess water that the body does not need. The primary functioning unit of the kidney is the nephron. The nephron is a microscopic unit that is made of the glomerulus, proximal convoluted tubule, loop of henle, distal convoluted tubule, and the collecting duct (McCance & Huether, 2014). Plasma is filtered through the afferent arteriole into the glomerulus then travels through the entire nephron to create urine. The loop of henle plays a vital role in electrolyte and fluid balance. The descending loop of henle is highly permeable to water and the ascending loop of henle is highly permeable to ions. It is essential to monitor GFR, BUN, and creatinine levels in patients to determine if renal functioning is adequate.\u202f<\/span>\u00a0<\/span><\/p>\nMcCance, K. L. & Huether, S. E. (2014). Structure and function of the renal and urologic system,\u202f<\/span>Pathophysiology: The biologic basis for disease in adults and children, seventh edition\u202f<\/span><\/i>(1319-1338). St. Louis, Missouri: Elsevier Mosby<\/span>\u00a0<\/span><\/p>\n\u00a0classmates, from this week lesson, it was refreshing\u202freviewing the anatomy\u202fand\u202ffunctions\u202fof the renal and urologic organs especially the kidneys\u202f(McCance, Huether, Brashers, & Rote, 2013). I gained more knowledge about various urinary tract infections, both descending and ascending infections. Renal disorders such as; Acute and chronic glomerulonephritis, acute tubular necrosis (ATN), their individual\u202fpathophysiology, and how they could both lead to kidney failure if not promptly and properly managed.\u202f<\/span><\/p>\nI learned about the causes, stages, and clinical manifestations of both acute kidney injury and chronic kidney failure\u202f(McCance, Huether, Brashers, & Rote, 2013). \u202fAnother notable important reminder from this week lesson was about the decrease in glomerular filtration rate with aging, hence as a medication prescriber, one must be mindful of drug dosing for the elderly population to avoid medication toxicity due to lack of clearance which may result in a sort of kidney damage and other complications (Chamberlain College of Nursing, 2018).<\/span>\u00a0<\/span><\/p>\nFinally, I also learn about different renal and urologic impairment in children some of which are congenital in origin.<\/span>\u00a0<\/span><\/p>\n\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f<\/span>\u00a0<\/span><\/p>\n\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f References<\/span>\u00a0<\/span><\/h3>\nChamberlain College of Nursing. (2018). NR -507\u202fweek\u202f4 alteration in renal\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f function (online\u202flesson). Downers Grove, IL. DeVry Education Group.\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f Retrieved from\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202fhttps:\/\/chamberlain.instructure.com\/courses\/30057\/pages\/week-\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f4-lesson?module_item_id=3471558<\/span>\u00a0<\/span><\/p>\nMcCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S.\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f(2013).\u202f<\/span>Pathophysiology: The biologic basis for disease in adults and\u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202f \u202fchildren<\/span><\/i>\u202f(7th ed.). St. Louis, MO: Mosby.<\/span>\u00a0<\/span><\/p>\n\u202f<\/span>\u00a0<\/span><\/p>\n\u202f<\/span> \u202f\u202f\u202f\u202f\u202f\u202f\u202f\u202f\u202f\u202f\u202f This week our primary focus is on the renal system. I have always been fascinated with the renal system because it plays such a vital role in filtering out the unwanted substances in the blood stream and can affect all other body organs if the process is interrupted. In the healthcare field I feel it is very common to see renal diagnosis and complications of some diseases such as chronic renal disease. My grandmother had chronic renal disease and it was a long process that involved dialysis and many other health conditions as a result of the renal disease. One topic that I always find interesting in the renal system is obstruction such as kidney stones. <\/span><\/p>\nWhile reading this week I found it interesting that depending on where the obstruction is located highly impacts the complications that arise. I have seen many individuals who have kidney stones present with severe flank pain, nausea, and vomiting. I have always found it interesting calcium is one of the main culprits of kidney stone formation. I have visualized a passed kidney stone before and was surprised that something so small can cause so much discomfort however, I have also visualized stones that I would have thought impossible to pass without surgical intervention. <\/span><\/p>\nHealthcare continues to advance with treatment techniques to remove stones from the ureters of patients who will not be able to pass the stones on their own. I feel this is a very interesting topic along with all of the other great information learned this week in regards to the renal system. This week is also our midterm and I must admit I am very nervous to see the questions that will be asked. I have spent the week in an attempt to review all of the learned information and focus in on the study guide outline. I hope everyone succeeds and does great on the midterm and can continue our journeys to becoming advanced practice nurses.<\/span>\u00a0<\/span><\/p>\nReference<\/span>\u00a0<\/span><\/h3>\nMcCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2014).\u202f<\/span>Pathophysiology: The biologic basis for disease in adults and children<\/span><\/i>\u202f(7th ed.). St. Louis, Missouri: Mosby. Chapter 38.<\/span>\u00a0<\/span><\/p>\nThis has been a very informative week as we gained a deeper understanding of the renal system, its pathophysiology, the different disorders that stem from the kidneys and their causes, and what we often see in the hospital as manifestations of acute and chronic kidney failure (McCance & Huether, 2014). The kidneys play a vital role in helping to maintain homeostasis within our bodies by regulating fluid volume and removing toxins and waste our bodies produce. They use many different mediators to help in this role including adenosine, natriuretic peptides, etc. which help to maintain renal blow and different functions of the kidneys such as diuresis (McCance & Huether, 2014). <\/span><\/p>\nOne of the procedures perfumed in my department quite often is a paracentesis where we drain ascitic fluid from a patient; while the main cause is usually directed at the liver, the kidneys can also be a culprit for this condition. Having a full understanding of the pathophysiology behind the renal system will help to educate and answer questions patients are having as to why this is happening, why the fluid \u201ckeeps coming back\u201d, etc. I also appreciated the refresher on how the filtration rate starts to decline in aging patients; this is a major consideration in prescribing medications to elderly patients and how the effects of medication and their durations change because of having a reduced filtration rate (McCance & Huether, 2014).<\/span>\u00a0<\/span><\/p>\nMcCance, K. L. & Huether, S. E. (2014). Structure and Function of the Renal and Urologic Systems,\u202f<\/span>Pathophysiology: The biologic basis for disease in adults and children, seventh edition\u202f<\/span><\/i>(1063-1068). St. Louis, Missouri: Elsevier Mosby<\/span>\u00a0<\/span><\/p>\n\u202f<\/span> This week has been a very interesting week with regards to our readings and trying to study for the midterm exam.\u202f We covered some great topics this week and I leaned towards the renal system and its function.\u202f At the beginning of my nursing career I worked on a Med\/Surg unit and of course we had our fair share of UTI’s and Rental stone patients.\u202f<\/span>\u00a0<\/span><\/p>\n\n- Kidney stone<\/span><\/b>\u202f\u2013 kidney stones affects 10% of people between the ages of twenty and sixty years old, and a recurrence rate within 5-10 years (Dawson & Tomson, 2012). Kidney stones are a result of the growth of crystals into stones.\u202f\u202f These crystals are formed in urine that is supersaturated with particular salts such as calcium oxalate, sodium urate, magnesium ammonium phosphate, or cysteine (Sakhaee, 2014). There are mainly four types of kidney stones.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Calcium oxalate stones are the most common type of stones, accounting for over 70% of all stones. These stones develop under a high degree of supersaturation, crystallization inhibitors, and urinary stagnation. Supersaturation occurs with high concentration of salt within the urine. These stones typically form by eating too much calcium or vitamin D. Genetics and certain medications can increase formation also (Rajat, Anu, & Sumeet, 2011).\u202f<\/span>\u00a0<\/span><\/p>\nKidney stones tend to be located either at the area of prior injury or in gravity dependent locations such as lower pole calices. These stones can be small or large in size. Depending on the size of the stone, it can either be voided with urination, or if the stone is too large, lithotripsy or surgery may be required (Malan et al., 2011).\u202f Depending on the size of the stones, individuals may experience considerable pain during their journey through the urinary tract due to the sharp edges of the large stones that may gouge into the walls of the ureters and sometimes the urethra. <\/span><\/p>\nThis severe pain is called renal colic, and comes in waves that may cause the person to double over. Pain may be localized in the flank or pelvic area, and often to one side. Other symptoms include; nausea, vomiting, fever, sweating, difficulty voiding, and possible hematuria.<\/span>\u00a0<\/span><\/p>\nReference<\/span>\u00a0<\/span><\/h3>\nDawson, C. H., & Tomson, C. V. (2012). Kidney stone disease: pathophysiology, investigation and medical treatment.\u202f<\/span>Clinical Medicine<\/span><\/i>,\u202f<\/span>12<\/span><\/i>(5), 467-471.<\/span>\u00a0<\/span><\/p>\nRajat, M., Anu, W., Sumeet, G. (2011). New Frontiers on Nephrolithiasis: Pathophysiology andManagement of Kidney Stones.\u202f<\/span>International Journal of Research in Avurveda & Pharmacy, 2<\/span><\/i>(3), 775-786.<\/span>\u00a0<\/span><\/p>\nSakhaee, K. (2014). Epidemiology and clinical pathophysiology of uric acid kidney stones.\u202f<\/span>Journal Of Nephrology<\/span><\/i>,\u202f<\/span>27<\/span><\/i>(3), 241-245. doi:10.1007\/s40620-013-0034-z<\/span>\u00a0<\/span><\/p>\nThis week has enlightened me more on the renal system and especially the nephron which is the functional unit of the kidney. There are three types\u202fof nephrons.\u202f1. superficial cortical nephrons<\/span>
\n2. mid-cortical nephrons<\/span>
\n3. Juxtamedullary nephrons<\/span> NR 507 Week 4: Alterations in Renal and Urinary<\/span><\/p>\nSuperficial cortical nephrons account for 85% of nephrons which extend partially to the medulla.\u202fsuperficial\u202fnephrons\u202fhave glomeruli located near the surface of the kidney and give rise to short-loop\u202fnephrons.\u202f<\/span>\u00a0<\/span><\/p>\nMid-cortical nephron: Mid-cortical\u202fnephrons\u202fhave glomeruli located between the superficial and juxtamedullary glomeruli\u202fand have short or long loops. The deeper the location of the glomerulus, the greater the likelihood that its tubule will descend into the inner medulla.<\/span>\u00a0<\/span><\/p>\nJuxtamedullary nephrons:\u202fJuxtamedullary\u202fnephrons\u202fhave glomeruli, that are located deep within the cortex, near the cortico-medullary border, and give rise to long-loop\u202fnephrons.<\/span>\u00a0<\/span><\/p>\nReferences<\/span>\u00a0<\/span><\/h3>\nBasiratnia, M., Kosimov, M., Farhadi, P., Azimi, A., & Hooman, N. (2017). Urinary Calprotectin as a Marker to Distinguish Functional and Structural Acute Kidney Injury in Pediatric Population.\u202f<\/span>Iranian Journal Of Pediatrics<\/span><\/i>,\u202f<\/span>27<\/span><\/i>(5), 1-6. doi:10.5812\/ijp.9727<\/span> NR 507 Week 4: Alterations in Renal and Urinary<\/span><\/p>\nReading about the structure and function of the renal system this week has been a great refresher.<\/span>\u00a0<\/span><\/p>\nI administer many medications that have a direct or indirect effect on kidneys to my patients.\u202f\u202fFor example, diuretics such as Lasix (Furosemide) or Spironolactone are popular medications used in the hospital.\u202f\u202fIt is important to monitor potassium levels, blood pressure and urinary output when administering diuretics especially Lasix.\u202f\u202fDiuretics increase urine flow and decrease extracellular fluid volume. They are used to treat edema and hypertension secondary to heart failure.\u202f\u202f<\/span><\/p>\nLasix blocks active transport of chloride, sodium, and potassium which can cause hypokalemia and uric acid retention and may alter acid-base and electrolytes.\u202f\u202fThere are many types of diuretics which work in different areas of the renal system.\u202fIn most cases, hypokalemia is a side effect of diuretics accept for potassium sparing diuretics such as Spironolactone.\u202f\u202fSpironolactone, a potassium-sparing diuretic, retain potassium and may cause hyperkalemia, nausea, and confusion (Doig and Huether, 2014).<\/span> NR 507 Week 4: Alterations in Renal and Urinary<\/span><\/p>\nReference<\/span>\u00a0<\/span><\/h3>\nHuether, S., & Doig, A. (2014). Structure and function of the renal and urologic systems. In K. McCance, S. Huether, V. Brashers, & N. Rote,\u202f<\/span>Pathophysciology: The Biologic Basis for Disease in Adults and Children Vol. 2<\/span><\/i>(p. 1333). St. Louis: Elsevier Mosby.<\/span> ![\"NR](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/09\/Downloader.la-649b1d35b7dc4-300x204.webp\")
<\/span><\/p>\n\u202f<\/span> I apologize for the post being so late but my work schedule has been horrific as I have been working from 7am to 2am.\u202f No excuses.\u202f This week, the Renal and Urologic Systems were covered and I learned about the structure and function, alterations of the renal and urinary tract functions in adults as well as children.\u202f Having sent an elderly person out to the emergency for a urinary tract obstruction, it was noted that her diet consisted of drinking tea to which she had a stone.\u202f Many of my patients have a diagnosis of neurogenic bladder as well as the common overactive bladder syndrome.\u202f<\/span><\/p>\n