Author Question: A nurse is teaching a nursing student about the effects of a sustained drop in systemic blood ... (Read 46 times)

Alygatorr01285 · **on:** Jun 25, 2018

A nurse is teaching a nursing student about the effects of a sustained drop in systemic blood pressure on the juxtaglomerular cells of the distal tubules in the kidneys.

The nurse knows teaching has been effective when the student identifies which type of medication as one that controls systemic blood pressure?

1. angiotensin converting enzyme (ACE) inhibitor
2. cardiac glycoside
3. thiazide diuretic
4. beta blocker

Question 2

The nurse is caring for a patient who has been diagnosed with an altered myogenic mechanism of the renal blood vessels. The patient asks,

Why is it so important that I treat my hypertension and keep my blood pressure within normal limits? How should the nurse respond to the patient?

1. Your kidneys may have difficulty protecting themselves from high blood pressure.
2. Your blood pressure medication is toxic to your kidneys in high doses.
3. If not controlled, the condition will require an indwelling urinary catheter.
4. High blood pressure increases your risk for kidney stones.

lauravaras · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
A sustained drop in systemic blood pressure triggers the juxtaglomerular cells to release renin. Renin acts on a plasma globulin, angiotensinogen, to release angiotensin I, which is in turn converted to angiotensin II. As a vasoconstrictor, angiotensin II activates vascular smooth muscle throughout the body, causing systemic blood pressure to rise. An angiotensin converting enzyme (ACE) inhibitor blocks the conversion of angiotensin I to the vasodilator angiotensin II. Cardiac glycosides, thiazide diuretics, and beta blockers will not affect the juxtaglomerular cells in the kidneys.

Answer to Question 2

Correct Answer: 1
The myogenic mechanism, one factor in renal autoregulation, responds to pressure changes in the renal blood vessels, controlling the diameter of afferent arterioles. An increase in systemic blood pressure causes the renal vessels to constrict, whereas a decrease in blood pressure causes the afferent arterioles to dilate. These changes adjust the glomerular hydrostatic pressure and, indirectly, maintain the GFR. An alteration in this system exposes the kidneys to pressures that are too high for proper long-term kidney function Elevated blood pressure does not require an indwelling urinary catheter. High blood pressure does not cause kidney stones.