Test 4/Week 10: Urinary Obstruction

Question 1

Urolithiasis

Answer 1

Formation of calculi in the kidney, bladder, urinary tract

Question 2

Nephrolithiasis

Answer 2

Calculi in the kidneys

Question 3

Hydronephrosis

Answer 3

Unilateral swelling of one kidney or stones: blockage in urinary tract causes backup of urine

Question 4

Urinary Obstruction Etiology

Answer 4

Causes differ by age:

Children: anatomic abnormalities

Young adults: calculi

Older adults: BPH/prostate CA, pelvic tumors, metastatic CA, calculi

Question 5

Urolithiasis Pt. Education (uric acid stones)

Answer 5

Uric acid stones: low purine diet, limit shellfish, mussels, asparagus, mushrooms, organ meat, keep urine basic

Prevention is best, dietary changes for type of stone
calcium stones: low protein
Oxalate stones: limit dark greens, chocolate, strawberries, peanuts

Question 6

ESWL

Answer 6

Extracorporeal shockwave lithotripsy

Anesthesia required, 90% successful stone clearance, no anticoagulants, hematuria expected

Question 7

Assessment/Care of Nephrostomy

Answer 7

I/O 1-2hrs, never clamp, rarely irrigated (must have orders and be sterile)

Call MD if: decreased UO, dislodged

Question 8

Types of Urinary Diversion

Answer 8

Based on: age, bladder condition, ability to learn/willingness to participate

Continent: valve is present
Incontinent: bag lasts 3-5 days, empty when a third to half full, maintain clear, dry skin around stoma (educate mucous may be normal)