Pediatric CCRN -
Endocrine/Hematology/GI/Renal/Integum
entary -Questions and Answers.
kidneys receive __% of cardiac output -
\25
Smallest functioning unit of kidney? -
\Nephrons
What is the glomerulus? -
\-composed of glomerular capillary bed and bowman's capsule
-filters plasma
Main functions of the kidneys -
\maintain fluid and electrolytes
rids body of waste products
dual role in acid-base balance
hormonal-endocrine fxn
Kidney conserves or eliminates water based on hormonal levels of _____ -
\ADH
ADH is secreted by -
\posterior pituitary
Characterized by water intoxication due to inappropriate ADH secretion -
\SIADH (syndrome of inappropriate adh)
Characterized by water loss and increased UOP due to low or absent ADH -
\DI (Diabetes insipidus)
Secreted by the juxtaglomerular apparatus
Generates sythesis of angiotensin II
Increase BP- helps maintain perfusion -
\Renin
Secreted by the adrenal cortext due to serum Na levels, K levels, ACTH, Angiotensin II -
\Aldosterone
This hormone increases Na+ absorption, eliminates serum K, and works at the distal
tubule and collecting ducts -
\Aldosterone
, parathyroid hormone -
\Secreted by the parathyroid gland
Actions:
-Increases reabsorption of Ca++ in kidney
-Increases serum Ca++ levels
-Works at the distal tubule & collecting ducts
Erythropoietin Factor -
\Often stimulated by decrease in pO2
Secreted by the kidney
Stimulates stem cells to produce erythrocytes
*main reason for anemia in chronic kidney pts
Normal GFR -
\132ml/min
Three phases of urine production -
\1. ultrafiltration
2. reabsorption
3. secretion
Normal urine production rate -
\Infants: 1ml - 3 ml /kg/hr
Children: ≥ 1 ml/kg/hr
Adolescents: ≥ 1ml/min = 60 ml/hr
Most sensitive marker of kidney fxn available -
\serum creatinine
Acute kidney injury -
\• Acute kidney injury, formally known as acute renal failure, represents an abrupt
decline in kidney function, resulting in inability to maintain fluid and electrolyte balance
and excrete nitrogenous wastes
• AKI is commonly defined as an abrupt (within 48 hours) reduction in kidney function
based on an increase in serum creatine level, a reduction in urine output, and the need
for dialysis, or a combination of these factors
• AKI can be caused by several types of conditions, including a decrease in blood flow
without ischemic injury; ischemic, toxic, or obstructive tubular injury; and obstruction of
urinary tract outflow
• The causes of AKI commonly are categorized as prerenal, intrarenal, and postrenal
• A major concern in the treatment of AKI is identifying and correcting the cause
• Either hemodialysis or continuous renal replacement therapy may be indicated when
nitrogenous wastes and the water and electrolyte balance cannot be kept under control
by other means
Endocrine/Hematology/GI/Renal/Integum
entary -Questions and Answers.
kidneys receive __% of cardiac output -
\25
Smallest functioning unit of kidney? -
\Nephrons
What is the glomerulus? -
\-composed of glomerular capillary bed and bowman's capsule
-filters plasma
Main functions of the kidneys -
\maintain fluid and electrolytes
rids body of waste products
dual role in acid-base balance
hormonal-endocrine fxn
Kidney conserves or eliminates water based on hormonal levels of _____ -
\ADH
ADH is secreted by -
\posterior pituitary
Characterized by water intoxication due to inappropriate ADH secretion -
\SIADH (syndrome of inappropriate adh)
Characterized by water loss and increased UOP due to low or absent ADH -
\DI (Diabetes insipidus)
Secreted by the juxtaglomerular apparatus
Generates sythesis of angiotensin II
Increase BP- helps maintain perfusion -
\Renin
Secreted by the adrenal cortext due to serum Na levels, K levels, ACTH, Angiotensin II -
\Aldosterone
This hormone increases Na+ absorption, eliminates serum K, and works at the distal
tubule and collecting ducts -
\Aldosterone
, parathyroid hormone -
\Secreted by the parathyroid gland
Actions:
-Increases reabsorption of Ca++ in kidney
-Increases serum Ca++ levels
-Works at the distal tubule & collecting ducts
Erythropoietin Factor -
\Often stimulated by decrease in pO2
Secreted by the kidney
Stimulates stem cells to produce erythrocytes
*main reason for anemia in chronic kidney pts
Normal GFR -
\132ml/min
Three phases of urine production -
\1. ultrafiltration
2. reabsorption
3. secretion
Normal urine production rate -
\Infants: 1ml - 3 ml /kg/hr
Children: ≥ 1 ml/kg/hr
Adolescents: ≥ 1ml/min = 60 ml/hr
Most sensitive marker of kidney fxn available -
\serum creatinine
Acute kidney injury -
\• Acute kidney injury, formally known as acute renal failure, represents an abrupt
decline in kidney function, resulting in inability to maintain fluid and electrolyte balance
and excrete nitrogenous wastes
• AKI is commonly defined as an abrupt (within 48 hours) reduction in kidney function
based on an increase in serum creatine level, a reduction in urine output, and the need
for dialysis, or a combination of these factors
• AKI can be caused by several types of conditions, including a decrease in blood flow
without ischemic injury; ischemic, toxic, or obstructive tubular injury; and obstruction of
urinary tract outflow
• The causes of AKI commonly are categorized as prerenal, intrarenal, and postrenal
• A major concern in the treatment of AKI is identifying and correcting the cause
• Either hemodialysis or continuous renal replacement therapy may be indicated when
nitrogenous wastes and the water and electrolyte balance cannot be kept under control
by other means
