Exam 1 Material : Renal Urinary Obstruction

Question 1

What is another name for Urinary Obstruction?

Answer 1

Calculi or Nephrolithiasis

Question 2

True or false? Women at the ages of 20 to 55 are more likely to develop a urinary calculi?

Answer 2

False. Males at the ages of 20 to 55 are more likely.

Question 3

Is recurring urinary obstruction common?

Answer 3

True

Question 4

What are the risk factors of Nephrolithiasis?

Answer 4

Hot climate, dehydration, low fluid intake

Large intake of calcium

Large intake of proteins (uric acid)

Family history

Sedentary lifestyle,

immobility

Question 5

What are the different types of Calculi?

Answer 5

Calcium Oxalate (most common)

Calcium Phosphate

Question 6

What can cause an increased risk for Calcium Oxalate?

Answer 6

Drinking lots of fruit juices and tea

Question 7

What can Calculi stones be made of?

Answer 7

Uric acid

Cystine

Struvite

Question 8

What are the clinical manifestations for Calculi?

Answer 8

Sudden onset of severe pain. General locations include:

Flank, lower abdomen, back and groin.

For men: Testicular pain

For women: Labial pain

Dysuria, Fever, and chills may also be present if UTI is also present with the obstruction

For nonobstructive stones = No possible pain

Question 9

How to assess for Renal Calculi?

Answer 9

Percuss at the Costovertebral angle

Question 10

What are the non-pharm care for a Renal Calculi that is less than <7 mm big?

Answer 10

Pain management

Antibiotics (if infection present)

Identify type and cause

Adequate hydration

Avoid soda, coffee, tea

Low sodium, avoid too much calcium & purine

Question 11

What are the non-pharm care for a Renal Calculi that is greater than 7 mm big or if the stone is too big to pass?

Answer 11

Cystoscopy

Cystoscopic lithotripsy

Ureterscope

Percutaneous nephrolithotomy with nephrostomy tube

Question 12

What should a nurse be aware of if a patient has gone through a lithotripsy?

Answer 12

Hematuria is common after the procedure but the urine is usually pink-tinged. If the urine looks blood red, it is an emergency and physician needs to be contacted.

Question 13

What should the nurse monitor for whenever a patient goes through any kidney procedures?

Answer 13

Changes in VS

Serial CBC every 6 hours for first 18 hours. Look for drop in HCT and HBG

Look for bleeding and hematoma formation at the flank side.