nephrolithiasis (W3) Flashcards
what is nephrolithiasis?
kidney stones
nephro
kidney
renal
belonging to kidney
nephrology
study of kidneys
urology
study of urinary tract
lithos
stone
calculi
stone where it shouldn’t be
where can a blockage occur?
kidneys
ureters
bladder
ureter opening
urethra
*remember the closer the block is to the kidneys, the more likely there is kidney damage
factors that determine how destructive an obstruction is
degree, location, duration, time
renal pelvis obstruction
renal calculi
ureter obstruction
renal calculi, pregnancy, tumor
bladder and ureter obstruction
bladder cancer, neurogenic bladder, prostatic hyperplasia, prostate cancer, urethral strictures
complications of an obstruction
- stasis of urine flow, increases risk of infection
- back up pressure- hydroureter, hydronephrosis, post renal kidney injury (because of blackage below them)
what are manifestations of acute obstruction?
depends on site, cause, speed of onset
primary factor: location of pain, comes in waves
so what is nephrolithiasis?
renal calculi or kidney stones
forms in renal pelvis
located from renal pelvis to bladder, excreted via utrethra
defined as: clumps of crystals in the urinary tract
risk factors of nephrolithiasis
men
obese
young (20-30 years old)
white
familial history
congenital defect
weather- hot because risk of dehydration
etiology of nephrolithiasis
crystallized solutes in urine
depends on: RF/urine characteristics/diet/medications (these things tell you about the kind of stone that is being formed)
types of nephrolithiasis
calcium oxalate, struvite, uric acid
calcium oxalate (75%)
RF: familial history, idiopathic, increased calcium, increated oxauria
struvite (7-10%)
RF: UTI
uric acid (7-10%)
RF: arthritis, GOUT
explain nephrolithiasis pathogenesis
urine is a solution of solvent AKA water and solutes AKA particles,
a problem occurs when super-saturated with a solute,
when this happens crystals begin to form in the nephron,
the formation is enhanced by dehydration and immobility/sedentary lifestyle
calcium oxalate stones
pass eventually
struvite “staghorn” calculus
can get really big, must be surgically removed
clinical manifestations of acute renal colic
location- flank to groin
radiation
spasms
intermittent
sharp
also… N/V
diaphoresis
increased HR/RR
nephrolithiasis pharm
acute pain
-morphine/NSAIDs until passed (helps with pain)
-IV fluids (to stay hydrated)
preventative
-calcium, thiazide diuretics
-struvite, antibiotics
-urate, allopurinol which reduces uric acid, used to prevent GOUT attacks
