Nursing Patients Notes Essay Sample

I. Describe the function of the undermentioned endocrines in the formation of piss. specifically explain the stimulation for their release. actions ( decrease/increase GFR ) and whether or non dilute/concentrated urine consequences ) :

ADH ( Vasopressin ) – ADH has an antidiuretic action that prevents the production of dilute piss. Formation of urine = in the DCT and roll uping canals. H2O motion out of the organic structure is regulated by ADH. Stimulus for their release = lowered blood force per unit area or low salt or H2O concentration in the blood will excite the release of ADH from the posterior hypophysis. Actions ( decrease/increase GFR ) = increased ADH would diminish the GFR and a lessening in ADH would increase GFR. Dilute/Concentrated Urine Results = if there is a high sum of ADH. H2O moves out and will bring forth concentrated piss and if ADH is absent H2O will non be reabsorbed and will bring forth dilute piss.

Renin-Angiotesin-Aldosterone System

Stimulation for their release = if blood force per unit area drops dramatically this will trip renin secernment from the JG cells. renin acts on angiotensinogen to organize angiotonin I. angiotonin I is converted to angiotensin II hence angiotensin II causes mean arterial force per unit area to lift and stimulates the adrenal cerebral mantle to let go of aldosterone. As a consequence. both systemic and glomerular hydrostatic force per unit area rises. Actions ( decrease/increase GFR ) = the motorial arteriole constricts. coercing blood to construct up in the glomerulus. which maintains the GFR. The activation of the RAAS causes a lessening in GFR. Dilute/Concentrated Urine Results = activation of the Renin-Angiotensin-Aldosterone System will ensue in concentrated urine consequences.

Atrial Naturetic Pepetide ( ANP ) Hormone

Stimulation for their release = big addition in blood volume promotes release of ANP. Actions = consequence is more urinary end product. less blood volume and decreased blood force per unit area. GFR will increase with the release of ANP. Dilute/Concentrated Urine Results = piss will be more dilute.

II. Diabetic patients ( with hyperglycaemia ) . typically have symptoms of polyuria. polydypsia and polyphagia. Define these footings and explicate why these patients are polyuric and polydypsic.

Polyuria is the inordinate secernment of piss. Polydypsia causes blood hyperosmolarity. this status activates the thirst centre in hypothalamus and makes the capable drink inordinate H2O.

Polyphagia is inordinate feeding.

Patients that are polyuric can hold diabetes. diabetes mellitus. premenstrual syndrome. urinary rocks. Common causes are bladder conditions. congestive bosom failure. cystitis. or generalized anxiousness upset. Uncommon causes causes include anorexia nervosa. interstitial cystitis. and sickle-cell anemia. Rare causes can be different types of malignant neoplastic disease. cushing’s syndrome and pituitary tumours.

Patients that are polydypsic can perchance be diagnosed with diabetes insipidus and diabetes mellitus. Often as one of the initial symptoms. and in those who fail to take their anti-diabetic medicines or whose doses have become unequal. It can besides be caused by a alteration in the osmolality of the extracellular fluids of the organic structure. hypokalemia. decreased blood volume and other conditions that create a H2O shortage. This is normally a consequence of osmotic diuresis. Polydipsia is besides a symptom of anticholinergic toxic condition. Zinc is besides known to cut down symptoms of polydipsia by doing the organic structure to absorb fluids more expeditiously ( decrease of diarrhoea induces irregularity ) and it causes the organic structure to retain more Na ; therefore a Zn lack can be a possible cause. Major tranquilizers can hold side effects such as dry oral cavity that may do the patient feel thirsty.

III. A 45-year-old patient was admitted to the infirmary with a diagnosing of cirrhosis of the liver. He is thin and malnourished. His venters is really big due to an accretion of fluid in the abdominal pit. His lower appendages are really conceited.

A. Explain why these alterations have occurred.

B. The nurse is detecting him closely for the possibility of GI hemorrhage. Why is this considered a possible complication?

C. Explain the consequence of his conditions on his GFR and why.

MODULE IV-TOPIC 2- DISCUSSIONS ( GRADED ) : ACID-BASE/pH-BALANCE

For full recognition. your engagement is require in at LEAST 3 ( Out of 4 ) of the clinical scenerios. Good fortune this hebdomad as you prepare for Module IV Lecture Exam with these constructs.

1. Gossip. an undergraduate. has normal PCO2 degrees. high H+ degrees. low pH and hydrogen carbonate degrees. What type of perturbation is Gossip enduring from and what might do this? If his PCO2 were elevated. would your reply alteration? Explain.

Gossip is sing metabolic acidosis. Metabolic acidosis focuses on reduced hydrogen carbonate and decreased pH degrees. Common causes are loss of hydrogen carbonate due to diarrhea. accretion of acid ( ketonemia ) . and nephritic disfunction. Yes. if PCO2 degrees were elevated but merely if she were to go on to hold low pH degrees. Gossip would most probably be sing respiratory acidosis because that is caused from addition PCO2 and decreased pH.

2. Diabetess mellitus produces many homeostatic instabilities. including acidosis. The pH instability is due to ketoacidosis. which consequences from inordinate accretion of by-products of fat metamorphosis. as the organic structure can non run into energy demands from saccharide metamorphosis. Sally is a adolescent diabetic who sometimes Rebels by non taking her insulin. Her female parent takes her to the infirmary because her external respiration has become deep and panting. Explain Sally’s take a breathing form. What other compensatory responses may happen and would they happen earlier or later than the respiratory response?

I think Sally is sing metabolic acidosis. and the respiratory response is hyperventilation which increases loss of CO2 hence the ground she is take a breathing profoundly and panting. Besides. if compensation is complete. pH will be within normal scope but HCO3- will be low.

3. Mary. a nursing pupil. has been caring for burn patients. She notices that they systematically show elevated degrees of K in their piss and admirations why. What would you state her?

Patients who have Burnss will lose a profuse sum of H2O. going hypovolaemic. every bit good as electrolytes and go dehydrated rapidly. The organic structure wants to seek and keep homeostasis so the Renin-Angiotensin-Aldosterone system will trip to conserve every bit much Na as possible ; for every three Na ions withheld in the system. the organic structure pumps two K ions out into urine elimination. The organic structure is seeking to keep on to more Na so there is more potassium being excreted in the piss.

4. Why does K concentration rise in patients with acidosis? What is this called? What effects does it hold?

MODULE V-TOPIC 1- DISCUSSIONS ( GRADED ) : Development

1. Describe the function of Corpus luteum:

1A. station ovulation and

1B. station nidation ( if gestation occurred )

2. A 25-year-old adult female stated that it had been six hebdomads since her last menstruations. Her gestation trial was positive. By the 6th month of gestation. she felt irregular contractions of the womb but no complications were present. After nine months. a healthy. 7 pound. . 3 oz miss was delivered with no complications. Breast eating was planned.

2A. What hormonal constituent is the footing of gestation trials?

2B. What prevented the womb from originating labour before the designated bringing clip?

2C. Describe the positive feedback systems that occur during labour and bringing

2D. What maintains milk production after birth?

2E. Is it possible to acquire pregnant during the clip of chest eating? Explain your reply. [ pic ] [ movie ] [ movie ]

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