A nurse is caring for a pregnant client who is experiencing increased urinary protein levels.
What is the primary cause of this change?
Decreased glomerular permeability.
Decreased protein intake.
Increased glomerular filtration rate.
Increased tubular reabsorption.
The Correct Answer is C
Increased glomerular filtration rate.
This is because during pregnancy, the renal blood flow and glomerular filtration rate increase to meet the increased metabolic demands of the mother and fetus.
This can result in increased urinary protein excretion, which is usually mild and does not indicate renal damage.
Choice A is wrong because decreased glomerular permeability would reduce the amount of protein that can pass through the glomerulus and into the urine.
Choice B is wrong because decreased protein intake would not affect the urinary protein levels, unless the intake is severely deficient.
Choice D is wrong because increased tubular reabsorption would decrease the amount of protein that is excreted in the urine, as the tubules would reabsorb more protein from the filtrate and return it to the blood.
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Related Questions
Correct Answer is D
Explanation
This is because a pregnant client may experience frequent urination at night due to increased urinary output caused by the increased blood volume and renal function during pregnancy.
This symptom is more common in the first and third trimesters.
Choice A is wrong because increased glomerular permeability does not cause nocturia, but it may cause proteinuria, which is the presence of protein in the urine.
Choice B is wrong because decreased renal blood flow does not cause nocturia, but it may cause renal ischemia, which is a condition where the kidneys do not receive enough blood supply.
Choice C is wrong because increased tubular reabsorption does not cause nocturia, but it may cause water retention and edema, which are swelling of the body tissues due to fluid accumulation.
Correct Answer is B
Explanation
Serum creatinine and urea are waste products of protein metabolism that are normally filtered by the kidneys and excreted in urine.
In pregnancy, the glomerular filtration rate (GFR) increases by about 50%, which means more creatinine and urea are cleared from the blood.Therefore, serum creatinine and urea levels decrease in pregnancy compared to nonpregnant women.
A. Increased serum creatinine and urea levels are wrong because they indicate impaired kidney function or dehydration, which are not normal in pregnancy.
C. Unchanged serum creatinine and urea levels are wrong because they do not reflect the increased GFR in pregnancy.
D. Increased glomerular filtration rate is correct but it is not a finding regarding serum creatinine and urea levels, which are the focus of the question.
Normal ranges for serum creatinine and urea vary depending on the laboratory and the units used, but based on a nonpregnant reference interval of 45-90 μmol/l (0.51-1.02 mg/dl) for creatinine and 2.5-6.4 mmol/l (7-18 mg/dl) for urea, a serum creatinine of >77 μmol/l (0.87 mg/dl) and a blood urea of >8.5 mmol/l (24 mg/dl) should be considered outside the normal range for pregnancy.
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