Chapter 25, Problem 2CCS

32-Year-Old Diabetic Male on a Diuretic

Let’s return to Kyle Boulard, whom we met in the previous chapter. Mr. Boulard has recovered from his acute diabetic crisis. The last update on his chart before he is discharged includes the following:

•BP 150/95, HR 75, temperature 37.2°C

•Urine: pH 6.9, negative for glucose and ketones: 24-hour urine collection reveals 170 mg albumin in urine per day

Mr. Boulard is prescribed a thiazide diuretic and an angiotensin converting enzyme (ACE) inhibitor. He is counseled on the importance of taking his medications regularly and keeping his outpatient follow-up appointments.

2. NCLEX-STYLE Mr. Boulard’s blood pressure is quite high. How would this affect his nephron function? Choose the statement below that is most accurate.

a. The kidneys normally increase their rate of filtration when blood pressure increases.

b. The kidneys normally increase their rate of reabsorption when blood pressure increases.

c. The kidneys normally increase both their rate of filtration and reabsorption when blood pressure increases.

d. The kidneys release more renin when blood pressure increases, activating the renin- angiotensin-aldosterone pathway.