A patient with impaired mobility which factor would contribute decreased kidney function:
Rationale: Harding, M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2020). Lewis’s Medical-surgical nursing : Assessment and management of clinical problems (11th ed.).). Elsevier, Inc.
A. Hypotension
B. Hypertension
C. Constipation
D. Peristalsis
The correct answer and explanation is:
The correct answer is A. Hypotension.
Explanation:
Impaired mobility can contribute to several physiological changes, including impacts on kidney function. One key factor that can lead to decreased kidney function is hypotension (low blood pressure). When blood pressure is too low, the kidneys do not receive enough blood flow, which is crucial for their ability to filter waste and maintain fluid and electrolyte balance. Here’s how hypotension affects kidney function:
- Reduced Renal Perfusion: The kidneys rely on adequate blood pressure to maintain a proper filtration rate. Blood carries oxygen and nutrients to the kidneys, and low blood pressure compromises this flow, leading to a decrease in the kidney’s ability to filter waste products from the blood. Chronic hypotension can lead to acute kidney injury (AKI) or chronic kidney disease (CKD) if not managed properly.
- Decreased Glomerular Filtration Rate (GFR): The glomeruli in the kidneys are responsible for filtering blood. When blood pressure is low, it reduces the force required to drive filtration, leading to a decrease in the glomerular filtration rate (GFR). A reduced GFR indicates impaired kidney function, meaning the kidneys are not filtering waste and excess fluids as efficiently.
- Activation of Compensatory Mechanisms: In response to hypotension, the body tries to compensate by activating systems like the renin-angiotensin-aldosterone system (RAAS), which aims to increase blood pressure. However, prolonged activation of these compensatory systems can contribute to damage to kidney structures, further impairing kidney function.
In contrast:
- Hypertension (B) increases the pressure within the kidneys’ blood vessels, which can lead to kidney damage over time, but it is typically a cause of decreased kidney function in the long term, not an immediate factor as with hypotension.
- Constipation (C) and peristalsis (D) are digestive issues that may cause discomfort or complications but do not directly impair kidney function.
Thus, hypotension is the primary factor among the choices that contributes to decreased kidney function in this scenario.