Page 1815 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 54

Renal and Urinary Problems

http://evolve.elsevier.com/Silvestri/comprehensiveRN/

Priority Concepts
Fluids and Electrolytes; Elimination

I. Anatomy and Physiology
A. Kidney anatomy
1. Each person has 2 kidneys, which are located behind
the peritoneum; attached at the level of the last
thoracic and first 3 lumbar vertebrae, on the right and
left sides.
2. The kidneys are enclosed in the renal capsule.
3. The renal cortex is the outer layer of the renal capsule,
which contains blood-filtering mechanisms
(glomeruli).
4. The renal medulla is the inner region, which contains
the renal pyramids and renal tubules.
5. Together, the renal cortex, pyramids, and medulla
constitute the parenchyma.
6. Nephrons
a. Located within the parenchyma
b. Composed of glomerulus and tubules
c. Selectively secretes and reabsorbs ions
and filtrates, including fluid, wastes,
electrolytes, acids, and bases

The nephrons are the functional units of

the kidney.
7. Glomerulus
a. Each nephron contains tufts of
capillaries, which filter large plasma
proteins and blood cells.
b. Blood flows into the glomerular
capillaries from the afferent arteriole
and flows out of the glomerular
capillaries into the efferent arteriole.
8. Bowman’s capsule

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