Renal System and Electrolytes

LA_StudentNurse · Apr 3, 2010

Exactly what are you having difficulty with? Effect of diuretics and/or different type of diuretics, ABGs, renal system's involvement in homeostasis, renal failure and fluid balance (fluid volume over load or deficit), s/s of chronic or acute renal failure and the effect on the body, meds to increase renal perfusion, how age affects renal function (neonate, infant, elderly), renal cancer; is it the way your textbook presents the info.....or is it all of the above and more?

Best to all

~Mi Vida Loca~RN, ASN, RN · Apr 3, 2010

This subject is my enemy so I am of little help!

LA_StudentNurse · Apr 4, 2010

This subject is my enemy so I am of little help!

Mi Vida Loca, live long enough and you will have personal interest in the renal system and electrolytes. Did you know that an elderly person's kidneys are two thirds of the size of those of a younger adults. Add in decreased renal profussion, HTN, DM, atherosclerosis, decreased urine concentration, use of diuretics, deminished thurst, decreased of water stores in the elderly--you may find that your interest in the renal system and electrolyte balance will increase.

~Mi Vida Loca~RN, ASN, RN · Apr 4, 2010

Mi Vida Loca, live long enough and you will have personal interest in the renal system and electrolytes. Did you know that an elderly person's kidneys are two thirds of the size of those of a younger adults. Add in decreased renal profussion, HTN, DM, atherosclerosis, decreased urine concentration, use of diuretics, deminished thurst, decreased of water stores in the elderly--you may find that your interest in the renal system and electrolyte balance will increase.

Yes and I also no that by the time s/s might occur in the elderly the kidney's might have lost 90% of their function. Or something like that.

The #1 cause of acute renal failure in children is dehydration.

I don't think their is any one system I am good at. But their are for sure systems that I stink in.

If I could go back and redo one set of classes, like if I knew then what I know now sort of thing, I would redo A&P and pay MUCH better attention. I have no idea how I even passed those classes to be honest.

LA_StudentNurse · Apr 4, 2010

Reason I know so much about renal/electrolytes is my mom had kidney CA and to make matters worse she had hyperkalemia. For the last 10 years it has been challenging. However, through atrophy, an elderly person's kidneys are only 1/3 of a regular kidney. Something to look forward to. Here's something interesting. Now that she is 90, it is difficult to interest her in food. She has normal b/p and no problem with NA+ so along with her medical drink, I started offering her frozen dinners--you know the type that is high in NA+. The NA+ does not affect her b/p, serum NA+. and she enjoys the variety found in the dinners. Since I started offering the dinners daily, she has consumed a little more calories and her K+ has decreased. Since there is an inverse relationship between K+ and NA+, I can only assume the connection is higher intake of NA+ is causing her K+ to go into her cells = decrease in circulating K+. Well, at least there is a good story about high fat and NA+ frozen dinners.

~Mi Vida Loca~RN, ASN, RN · Apr 4, 2010

Reason I know so much about renal/electrolytes is my mom had kidney CA and to make matters worse she had hyperkalemia. For the last 10 years it has been challenging. However, through atrophy, an elderly person's kidneys are only 1/3 of a regular kidney. Something to look forward to. Here's something interesting. Now that she is 90, it is difficult to interest her in food. She has normal b/p and no problem with NA+ so along with her medical drink, I started offering her frozen dinners--you know the type that is high in NA+. The NA+ does not affect her b/p, serum NA+. and she enjoys the variety found in the dinners. Since I started offering the dinners daily, she has consumed a little more calories and her K+ has decreased. Since there is an inverse relationship between K+ and NA+, I can only assume the connection is higher intake of NA+ is causing her K+ to go into her cells = decrease in circulating K+. Well, at least there is a good story about high fat and NA+ frozen dinners.

I just took care of a 92 yr old pt today that ONLY has a history of PUD and Alzhemiers (which I question that or she must be in very early stages) but her heath just took a huge dive. She had an ischemic CVA, blood pressure was in the 60/40, oliguria (I think I picked the right one. She only produced 30 ml in the 18 hrs she had been there and she had a foley) her H&H was extremely low. Like a 6.5 19% of something close but they found no source of bleed so thought maybe it was a production problem. She was on blood and within 3 hrs of the drip starting she had drastic improvement in her LOC and Speech (from where she was with the speech when she came in) slightly improved BP systolic wise but still no U/O. I had just colected a sample to send down again when I was would have loved to see the results but I had to go.

So taking that I struggle with this topic tell me if I am thinking right. With low Na+and water following salt would that leave a higher concentration of K+ but with he higher NA+ it is allowing more water into the cells thus balancing the K+ better?

trae55 · Apr 5, 2010

I'm studying this right now. It is confusing on where in the loop of henle everything is absorbed and reabsorbed. I finally just drew a chart. It's for pharm so I'm not even sure we'll be tested on it. Our teacher is more concerned about the nursing aspect than the a&p.

I always just remember water follows sodium and na is exchanged for potassium.

LA_StudentNurse · Apr 5, 2010

Heather, do a search. There should be charges on line that discuss which diuretic works where and its effect on the specific area of the kidney. If you can't find one, send me a private message and I will dig through my notes.

G