The nurse is caring for a patient with chronic renal failure. The ...

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The nurse is caring for a patient with chronic renal failure. The patient asks the nurse how his kidney disease causes hypertension. What is the nurse's best response?
 
  A) When blood flow to the kidney is under high pressure it causes release of antidiuretic hormone (ADH).
  B) When too much blood flows to the kidney, it causes vasodilation.
  C) When blood flow to the kidney declines, cells in the kidney release renin.
  D) Renin production converts ADH to angiotensin I in the liver.

Question 2

A patient is taking ethosuximide (Zarontin) for absence seizures. He or she complains of gastrointestinal (GI) upset associated with the drug. The nurse will encourage the patient to do what?
 
  A) Take the drug 1 hour before or 2 hours after a meal.
  B) Decrease the dosage.
  C) Take the drug with food.
  D) Discontinue the drug and ask his or her physician to prescribe another drug.

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Answer to Question 1

C
Feedback:
When blood flow to the kidneys is decreased, cells in the kidney release an enzyme called renin. Renin is transported to the liver, where it converts angiotensinogen (produced in the liver) to angiotensin I. Angiotensin I travels to the lungs, where it is converted by angiotensin-converting enzyme (ACE) to angiotensin II. Angiotensin II travels through the body and reacts with angiotensin II receptor sites on blood vessels to cause a severe vasoconstriction. This increases blood pressure and should increase blood flow to the kidneys to decrease the release of renin. Angiotensin II also causes the release of aldosterone from the cortex of the suprarenal glands, which causes retention of sodium and water, leading to the release of ADH to retain water and increase blood volume.

Answer to Question 2

C
Feedback:
If GI irritation occurs with ethosuximide, the patient should be encouraged to take the medication with food to reduce this adverse effect. A nurse would never tell a patient to decrease the dosage or discontinue a drug. That advice should only be given by the patient's medication prescriber. Taking the drug 1 to 2 hours after meals would not reduce this effect.

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Thank you!

[rekilledagain]

Always glad to help...