Renal Calculi Flashcards
Urinary calculi AKA
Kidney stones
Urinary calculi are caused by the development of
One or more crystals ranging in size from very small to large enough to fill the renal calyces
Lithiasis:
Stone formation
Nephrolithiasis
Stone formed in the kidney
Urolithiasis
Urinary tract stone formation
Stones cause excruciating _____ and extreme ____
Pain and irritation
Idiopathic:
Having no demonstrable cause
Greatest risk factor of stone formation
Prior personal or family history of urinary calculi
Other risk factors
Generic predisposition
Dehydration
Immobility
Excess dietary intake of Ca, oxalate, or proteins
What are some repeated infections that also contribute to calculus formation
Gout
Hyperparathyroidism
Urinary stasis
Most kidney calculi is composed of
Calcium oxalate and/or calcium phosphate
Utica acid stones develop when
Urine concentration of uric acid is high
Struvite calculi are associated with
UTI
Caused by bacteria such as Proteus
Prevention:
Adequate fluid intake
Dietary intake
Calcium stone are prevent by
Reducing sodium and animal protein intake
Gettin enough calcium from food
Avoiding foods high in oxalate (spinach, nuts, what bran)
Thiazides diuretics are used to prevent
Calcium stone
Allopurinol is used to prevent
Uric acid stones
Antibiotics may help prevent which stones
Struvite stones
Uric acid stones can be prevented by
Limiting animal protein intake
Renal colic
Acute, severe flank pain on the affected side
Gross hematuria is often only a sign of
Bladder stones
Calcium phosphate and/or oxalate management
Diet
Increased hydration
Exercise
Complications of urinary stones
Obstruction
Hydronephrosis
Infection
Hydronephrosis:
Accumulation of urine in the renal pelvis as a result of obstructed outflow
Diagnostic Tests
UA Chemical analysis of stone Urine Ca, uric acid, and oxalate levels Serum calcium, phosphorus, and uric acid levels A KUB Renal ultrasound CT scan of kidney IVP Cystoscopy
Lithotripsy
Using sound or shock waves to crush stone, it is preferred treatment for urinary calculi
Pyelolithotomy post op priority
Assess the pain level
T/F
When you are older, you are not as likely to pass the stone sponateously
True
Pharm therapy
Analgesic (narcotic)
Hydration
Diuretics depending on type
Non pharm
Increased water intake of at least 2 L per day
Activity
Dietary changes
Indomethacin
NSAID
Given as a suppository, may reduce the amount of narcotic analgesia required for acute renal colic
Diagnosis
Acute pain Impaired urinary elimination Deficient knowledge Anxiety Readiness for enhanced nutrition Risk for infection
Implement
Manage pain Monitor urinary output Provide patient teaching Promote Heath and wellness Prepare for discharge
Crystine
Substance that contributes to stone formation
Ureteral stone
Assessment finding
Microscopic hematuria
Renal colic
Fever
Colicky pain
Renal colic
Calcium phosphate kidney stone
Contributing factor
Consumption of goods high in calcium
Goods high in purine contribute to the formation of
Uric acid stone
T/F
Phosphate binds with calcium to decrease the blood level of calcium
True
Manifestations of urinary calculi
Immobility Dehydration Excess dietary oxalate Dietary K deficiency Family hx
Dehydration
Immobility
Family hx
Excess dietary oxalate
Gout
Prevent uric acid stones by teaching
Limit meat intake
This is high in purine
History of kidney stones in prego client
Prevention via
Increase fluid intake 2500-3500 mL/ day
Emptying the bladder completely prevents
Urinary staid
Follow up care for child previously treated for urolithiasis
24- hour urine sample
Includes urine calcium and uric acid levels
UA is an assessment for a
UTI
Exercise promotes
Calcium to move back into the bones
Renal colic treatment
Increasing fluid intake Increasing dietary fat intake Bed rest Avoiding excess Ca containing goods Admin ordered meds to prevent the formation of future stones
Increasing fluid
Avoid Ca
Admin ordered meds
Suspected urinary calculi
UA Chest X-Ray Renal ultrasound IVP CT scan of Kidney
UA (for hematuria, WBCs, and crystal fragments)
Renal ultrasound
IVP (visualize the kidneys, bladder, and ureter)
CT scan (show calculi and obstruction)
Acute hydronephrosis
Prescribed clinical therapy
IV therapy
Oral hydration
Thiazides diuretic
Calcium binding agents
IV therapy
Thiazides
Cloudy urine could be an indication of an
Infection
Ureteral stone manifestations
Acute severe flank pain
Cool, pale, and clammy skin
Assess vS
