Acute renal Lithiasis Flashcards
what is urinary obstruction
- any anatomical or functional condition that blocks or impedes the flow of urine
- Stones obstruct the flow of urine out of the body
- urine cannot move through
what are the risk factors?(6)
- metabolic issues
- dehydration
- genetics
- immobile
- certain diet
- high calcium and acid in urine
where are the location of the stones
kidney, ureter, bladder
what are the signs and symptoms
- very painful ( depending on the location of the stones )
- Kidney: patient will feel a real dull, costovertebral flank pain or renal colic
- Ureters: Intense colicky, patient may be in mild shock
what are the signs and symptoms of kidney stones?
patient will feel a real dull, costovertebral flank pain or renal colic
what are the signs and symptoms of ureter stones
Intense colicky, patient may be in mild shock (cool moist skin, N&V)
what are the diagnosis
- urinalysis
- urine culture
- cyctoscopy
- Xray
5 IVP
management id renal lithiasis consist of two approach
- treating the symptoms ( pain, infection, or obstruction)
2. evaluation of the cause of the stones formation and the prevention of further development of stones
what informations should we obtain to examine cause/ prevention
- family history of stone formation
- geographic residence
- nutritional assessment
- activity pattern
- history of disease and dehydration
what is lithotripsy?
involves the use of sound waves to break renal stones into small particles that can be eliminated from urinary tract.
how is surgery done?
- not commonly done
- surgeon removes the stones
when is surgery an option to remove stones
when patient is very obese or have some other complex abnormalities
Overall nursing care goal for patient with urinary tract calculi are
- relief pain
- ensure theres no urinary obstruction
- Understand what patient can do to prevent stones
- If theres infection get it treated
Nursing care for acute renal lithiasis
- pain control
- monitor urine amount/ colour
- “Strain” urine
- Ambulation
- Pt education
how do we control pain?
- pain is on and off
- pain is controlled by narcotics or any type of urinary analgesics or urinary antipasmic
how do we asses urine amount/ colour
- look at the amount and colour
- sometimes hard to tell the amount because stone happens only in 1 kidney at the time so you don’t know which kidney is damaged by looking at foley.
“strain” urine
- we want to strain the stones for analysis
- figure out what type and it will help with diagnosing the underlying problems
Depending on the type of stones, diet should be modified to decrease foods that are high in substance that cause the calculi
- purine
- calcium
- oxalate
why does patient needs to ambulate?
- promotes movement of stone from the upper to lower urinary tract
- Keep in mind safety and risk for fall ( dont let patiend walk alone)
Patient education: what is the main objective?
to prevent reoccurrence of the stones
how to we prevent recurrence of stones
- adequate fluid intake to produce a urine output of appropriate 3L/ day - helps urine to be more dilute so its not saturated with minerals
- diet limit oxylate ( spinach, cabbage, asparagus, tomatoes) and purines
- infection - be aware of S&S
does lithotripsy have any incisions?
no
what kind of procedure sedation lithotripsy uses
spinal anaesthetic or general, conscious sedation
how do we deal with pain in after lithotripsy
we give patient narcotics and decrease to ibuprofen or other analgesics
