Course Overview Welcome to the Team PD pre-work participant guide. Team PD is a new education program offered by Baxter that utilizes individual learning maps so nurses receive a personalized approach to learning about PD. During the pre-work phase, nurses will learn about, and are assessed on, their understanding of the basic concepts which are foundational to you PD education. The pre-work phase contains four modules: Renal Anatomy & Kidney Function Basic Fluid Transport Principles Kidney Disease Introduction to PD Please remember that based on your personalized learning plan and your past experience you may not be required to complete all four modules. Please use this guide to follow along with each of the pre-work modules available online via the links provided in you welcome letter and e-mail, or through playing the DVD included in this prework kit. For more information on this or other PD training, please contact your Baxter representative. 2007 by Baxter International 1
Learning Objectives By the end of this module, you will be able to: Identify the core components of the urinary system Name the major components of the kidney and identify their function Recognize the five functions of a healthy kidney Core Components of the Urinary System The urinary system is comprised of: Kidneys Bladder Inferior Vena Cava Abdonimal Aorta Ureters Urethra Location of Kidneys The kidneys and other organs are contained inside of the peritoneal cavity. Peritoneal membrane consists of two layers: Parietal layer lines the inner surface of the abdominal wall Visceral layer covers the abdominal organs The peritoneal membrane acts as a dialyzing membrane permitting waste from the body to cross it. There are two main properties that are required for ultrafiltration to occur efficiently: Semi-permeable a membrane that allows the passage of some molecules but prevents the passage of others Bi-directional substances can move in either direction across the membrane 2007 by Baxter International 2
The Major Components of the Kidney Renal Artery Medulla Cortex Nephrons Calyces Renal Pelvis Nephrons The nephron has two important parts: Glomerulus a tuft of capillaries that sits in a little catcher s mitt called the Bowman s capsule, likened to the head of a funnel System of tubules - connect to the kidney s ureter like a long and twisted funnel spout Ultrafiltration of the Blood in the Glomerulus Blood proteins and red blood cells do not pass through capillary wall Fluid and small solutes are push through capillary walls Note: The presence of protein in the urine may indicate structural damage or inflammation inside the glomerulus. This is often the first clinical sign of kidney disease. Primary Functions of the Kidney Remove waste Maintain fluid balance Maintain electrolyte balance Maintain acid-based balance Secrete hormones 2007 by Baxter International 3
Check Your Learning 1. Label the different components of the urinary system 2. What is located in the peritoneal membrane? 3. How do the properties of the peritoneal membrane affect ultrafiltration? 2007 by Baxter International 4
4. Major components of the kidney: unscramble the words below: a) lsyccae b) rocxet c) raeetlnarry (2 words) d) onrnhpes e) eevpinslrla (2 words) f) ledmalu Baxter PD Nurse Education 5. What are two important part of the nephron? 6. Describe the role of the glomerulus in the blood filtration process? 7. What is often the first clinical sign of kidney disease? 8. Apart from removing waste, what other unique functions do the kidneys have? 2007 by Baxter International 5
Answer Key 1. Label the different components of the urinary system Abdominal Aorta Inferior Vena Cava Kidneys Ureters Bladder Uretha 2. What is located in the peritoneal membrane? The peritoneal membrane is a porous layer of tissue with numerous blood vessels that surrounds the peritoneal cavity. The kidneys and other organs are contained inside of the peritoneal cavity 3. How do the properties of the peritoneal membrane affect ultrafiltration? The two main properties of the peritoneal membrane are: a) Semi-permeable a membrane that allows the passage of some molecules but prevents the passage of others b) Bi-directional substances can move in either direction across the membrane This is an important consideration for ultrafiltration to occur efficiently. 2007 by Baxter International 6
4. Major components of the kidney: unscramble the words below: a) lsyccae calyces b) rocxet cortex c) raeetlnarry renal artery (2 words) d) onrnhpes nephrons e) eevpinslrla renal pelvis (2 words) f) ledmalu medulla Baxter PD Nurse Education 5. What are two important part of the nephron? The nephron has two important parts: a tuft of capillaries called the glomerulus that sits in a little catcher s mitt called the Bowman s capsule, and a system of tubules which ultimately connect to the kidney s ureter. 6. Describe the role of the glomerulus in the blood filtration process? Blood enters the glomerulus from the larger-diameter arteriole on the bottom and exits through the narrowerdiameter arteriole at the top. Due to the action of the heart pumping blood through the body, and the narrower exit from the glomerulus, hydrostatic pressure builds up inside the capillaries. Fortunately, the capillary wall is also a very thin semi-permeable membrane. Due to the hydrostatic pressure on the blood-side of the membrane, fluid and small solutes -- in this case, the waste products creatinine; and excess salt -- are pushed through the semi-permeable membrane of the capillary walls and into Bowman s capsule, where they travel on into the tubules where some of it will eventually flow to the ureter. 7. What is often the first clinical sign of kidney disease? The first clinical sign of kidney disease is often the presence of protein in the urine, which may indicate structural damage or inflammation inside the glomerulus. 8. Apart from removing waste, what other unique functions do the kidneys have? Besides removing waste the kidneys have several other unique functions: They remove excess water to maintain fluid balance. They maintain our electrolyte balance. They maintain our acid-base balance. They secrete the hormones erythropoietin and renin. 2007 by Baxter International 7