Incivility In Nursing

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Case Study Questions: 1.) Explain the renin-angiotensin-aldosterone system. When the kidneys sense decreased profusion pressure, they try to increase this pressure by increasing blood volume through the renin-angiotension-aldosterone system. Once the decreased pressure is sensed renin is released, which increases conversion of angiotension to angiotension I. Angiotension I is in turn converted to angiotension II by the angiontension converting enzyme (ACE). Angiotension II causes vasoconstriction, which raises the blood pressure. Angiotension II also stimulates aldosterone release from the adrenal gland. This leads to increased sodium reabsorption by the kidneys, which causes water to follow it, which then increases intravascular volume. The increased vasoconstriction and increased blood volume raise the blood pressure. Additionally, the perceived hypovolumic status causes the release of antidiuretic hormone (ADH) from the posterior pituitary. ADH increases water reabsorption in the kidneys, which further contributes to increased volume and increased BP (McCance & Huether, 2010). 2.) What tests indicate glomerular function? Serum creatinine concentration, cystatin C plasma concentration, and BUN levels indicate glomerular function (McCance & Huether, 2010). 3.) Explain nephrotic syndrome and its characterizations. Nephrotic syndrome is a disorder of the glomerular filtration membrane that permits proteins (at least 3.5g) to pass into the urine resulting in protienuria, hypoalbuminemia, hyperlipidemia, lipiduria, Vit D deficiency, hypothyroidism and systemic edema. Nephrotic syndrome is more common in children than adults (McCance & Huether, 2010, p. 1384). 4.) What are some systemic effects of Chronic Kidney Disease? * Hyperphosphatemia results in hyperparathyroidism that can result in osteitis fibrosa- bone inflammation with fibrous
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