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What is the treatment for ascities?
- sodium restriction
- albumin infusion (keeps the water inside of the cells instead of in the peritoneal space)
- diuretics such as Spironolactone (Aldactone) to block aldosterone in distal tubal
What are the 3 major places that your total body water is distributed?
Intracellular fluid (65%)
- Interstitial fluid (25%)
- Plasma (8%)
A heart failure patient will have a ______ fluid balance
Positive (input > output)
- Net fluid movement into or out of the capillary
- Is determined by the difference between the forces favoring filtration and those opposing it (tug of war)
Interstitial hydrostatic pressure
Pushes water into the capillary
Interstitial oncotic pressure
Pulls water out of the capillary (this is very low pressure- little movement of water)
Capillary hydrostatic pressure
Pushing water out of the capillary
Capillary oncotic pressure
Pulling water into the capillary
Movement of water across cell membranes from less concentrated to more concentrated
The concentration of solute in a fluid (mostly sodium) per kg of water OR per L of solution (more clinically interpretable)
Movement of molecules from higher concentration to lower concentration.
Fluid and solutes move together across a membrane from an area of higher pressure to one of lower pressure
Substance moves across cell membranes from less concentrated solution to more concentrated; requires a carrier, and energy
What is the normal serum osmolarity?
275 to 295 milliosmoles/liter (mOsm/L)
What is the function of ADH?
Stimulates water conservation and the thirst center
What is the function of aldosterone?
Controls Na+ absorption and K+ loss along the descending convoluted tubules and collecting duct
What is the function of the natriuretic peptides (ANP/BNP)?
Reduce thirst and block the release of ADH and aldosterone
Where are barorecptors and osmoreceptors found?
- Baroreceptors: in the aorta and carotids
- Osmoreceptors: in the head and kidney inside the nephron
What are the major functions of the kidney?
- Fluid balance
- Solute concentration and dilution
- Acid-base balance
- Waste excretion
Describe autoregulation in terms of the kidney
The kidney controls the amount of blood that goes in and out of the organ; if the kidney detects a need for more blood it dilates its vessels, vasoconstricts if has too much blood inside of the kidney
What is the major measure of kidney function?
Glomerular filtration rate (GFR); based on creatine clearance. If the creatinine is high, then it means that the kidney is not functioning correctly
What does the Blood urea nitrogen (BUN) test for?
- Tests for hydration status. The higher the BUN,
- the more dehydrated the function
What two tests together can diagnose kidney disease?
GFR and BUN
GFR increases as arterial pressure _________
- *Hypertension if prolonged can cause kidney failure (esp. in African Americans)
What is a normal amount of daily urine output?
What does urine contain?
What is the normal pH of urine?
4.6-8.0 (slightly acidic)
What is the function of the juxta-glomerular apparatus (JGA)?
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