ACE inhibitor (Angio I not converted to Angio II)
1. this reduction of angio II decreases Aldosterone secretion & prevents Na & H2O
retention
2. so ↓peripheral vascular resistance and ↓ BP
6. Excretion of metabolic wastes & toxins:
a. metabolic wastes excreted into glomerular filtrate
b. creatinine contained in the glomerular filtrate & excreted unchanged into urine
c. other wastes such as urea are excreted unchanged in the glomerular filtrate but are
unchanged in the glomerular filtrate but are resorbed in part during passage thru nephron
d. thus the amount of waste material excreted in urine is only a portion of which was
originally contained in glomerular filtrate
e. most drugs are either secreted by kidneys or metabolized by liver & secreted by kidneys
f. if kidneys are impaired, some drugs are contraindicated or have a "renal dose"
ie. 1. antibiotics (Vancomycin), 2. salicylates, 3. long-acting barbituates
III. Factors that can affect Micturition: (T- 1488)
A. food & fluid kidneys help maintain a careful balance of fluid intake & output should be
equal "I & O"B.
B.dehydration kidneys resorb fluid [urine]
C. foods that increase urine output caffeine, alcohol (inhibit ADH), watermelon (↑H2O)
D. foods that decrease urine output salty, increase resorption / retention
E. foods that affect the smell of urine asparagus, onions
G. psychological some people are very private regarding elimination & have difficulty asking for
assistance stress can cause people to void small amount frequently. Perineal muscles & external
urethra sphincter to not relax, may not be able to void or completely empty
H. Activity & muscle tone regular exercise aids metabolism as well as optimal urine production
1. people who are bedridden or immobile for extended period of time can have poor urinary
control & urinary stasis
2. people who have a urinary catheter can lose bladder tone & can experience incontinence
when catheter removed
3. child birth ↓tone, ↓estrogen levels in menopause & damage to muscles
4. autonomic bladder flaccid bladder not controlled by brain due to injury, incontinence
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