Essentials of Pathophysiology: Concepts of Altered States
Essentials of Pathophysiology: Concepts of Altered States
4th Edition
ISBN: 9781451190809
Author: Carol Porth RN MSN PhD
Publisher: LIPPINCOTT WILLIAMS+WILKINS
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Chapter 25, Problem 1RE

A.

Summary Introduction

To determine: The probable cause of the boy’s glomerular disease.

Introduction: Glomerular disorders are related to the most common forms of kidney disorders. The glomeruli are the primary site of disease and can be secondary if affect the other organs. Glomerular diseases may lead to renal failures.

A.

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Two immune mechanisms may lead to glomerular injuries: injuring due to antibody and antigens planted within the glomerulus and injury from circulating antigen-antibody that traps in the membrane of glomerulus. The acute post-infectious glomerulonephritis is caused due to infection with different strains of bacteria belonging to A β-hemolytic streptococci and deposition of immune complexes. The condition may also occur after infections by staphylococci and viral infections such as chickenpox and measles.

B.

Summary Introduction

To determine: Interpretation of the laboratory test results and significant values.

Introduction: The glomeruli consists of a dense network of capillaries. The factors responsible for triggering injuries in glomerulus include pathogens, immunologic mechanisms, drugs, and environmental agents. The conditions like diabetes, hypertension, drugs, and chemicals induce glomerular injury.

B.

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Glomerulonephritis is adisease that affects the glomeruli of the kidney. The laboratory test of the condition involves a urine test that shows protein and blood cells present in the urine. The presence of urine protein can be detected by urinalysis by a separate dipstick test. The creatinine level in the boy is 4.1 mg/dL, and albumin is 2 g/dL, which is relatively higher and shows a kidney impairment. The Blood urea nitrogen or BUN is 62 mg/dL, whereas for an average person is around 8-20 mg/dL. The increased BUN signifies the decrease in kidney function. However, the bicarbonate level is less than the average value, which is 24-31m Eq/L, which shows metabolic acidosis. The low hematocrit also shows a low percentage of red blood cells.

C.

Summary Introduction

To determine: Whether the boy is progressing towards uremia.

Introduction: The uremia is a condition in the kidneys where the high levels of urea are present in the blood. The urea is a nitrogenous waste that is a component of urine. This condition is reached when a high amount of amino acid or protein is metabolized to release urea and creatinine in the blood.

C.

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The glomerular damage may lead to an increase in permeability to the proteins in the blood, which results in proteinuria. The abnormal functioning of the glomerulus leads to a nephrotic syndrome, which leads to loss of plasma proteins into the blood. Due to the low urine output, fluid retention may give rise to edema, water intoxication, and pulmonary congestion. The Uremia represents the urine present in the blood, which may lead to kidney failure due to the accumulation of the nitrogenous waste, urea in the blood.

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Chapter 25 Solutions

Essentials of Pathophysiology: Concepts of Altered States

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