Answer to Question 1
Review of basic guidelines for phosphorous and potassium restriction (discussing high- and low-forms of food); encouragement of adequate kilocalories and protein with suggestions to maximize PO intake in face of her current symptoms of nausea and dysgeusia.
Answer to Question 2
The brain integrates information from sensors called baroreceptors that continually measure blood pressure.
Various hormones such as norepinephrine and epinephrine control resistance of the blood vessels.
- Norephinephrine acts as a vasoconstrictor. When the diameter of blood vessels is decreased (either by norepinephrine or by a disease process such as atherosclerosis), blood pressure will increase.
- Vasodilation will decrease blood pressure.
Other hormones including aldosterone and vasopressin (ADH) also assist in blood pressure control.
- Aldosterone is released to increase sodium reabsorption and, with vasopressin, will increase water resorption and blood volume, leading to an increase in blood pressure.
Additionally, the kidneys respond to their own baroreceptors.
- If blood pressure is low, renin is released, which in turn controls the levels of angiotensin II, which causes vasoconstriction and thus also increases blood pressure.
Proper renal function is necessary for the actions of RAAS and thus abnormalities in BP can be seen in conditions like chronic kidney disease and acute kidney injury.
All of these responses cause an overall increase in heart rate, stroke volume, and, ultimately, blood pressure.
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