Urinary Calculi Flashcards
Urinary calculi typically occurs in patients of what age range?
30s to 50s
Urinary calculi typically are more frequent in which gender?
Men
If you have on urinary calculi when are you likely to experience another one?
in the next 5 years
Kidney stones can range from what sizes?
A grain of sand to as big as an orange.
What is an urinary calculi also called?
Kidney stone
What does lithiasis mean?
Stone formation
What does nephrolithiasis mean?
Stones form in kidney
What does Urolithiasis mean?
Stones form elsewhere in urinary tract
Where do kidney stones lodge?
Anywhere in the urinary tract
What types of symptoms can a patient have if they have a kidney stone?
They can be asymptomatic for very painful.
What are kidney stones normally made of?
Calcium
What are the stimuli for forming kidney stones?
-Urinary stasis -immobility -Infection
What type of diets can contribute to a patient forming kidney stones?
-A diet high in calcium -Meals high in insoluble salt. -Lack of fluid intake
Other than a stimulus for formation of kidney stones and a patients diet what other factors can contribute to kidney stones?
-Certain medications -Lack of inhibitory substances in urine -Supersaturation
Calcium oxalate and/or calcium phosphate kidney stones make up what percentage of cases?
75%
Uric acid kidney stones make up what percentage of cases?
5-10%
What makes up a struvite stone?
Ammonia rich, alkaline urine.
Where do most kidney stones form?
In the renal pelvis
How can kidney stones lead to kidney failure?
They block the ureters
Most kidney stones are what?
Idiopathic
True or False: Prior personal or family history of kidney stones elevates your risk of kidney stones.
True
What are the two ways that calcium can make kidney stones?
By having excess dietary intake of calcium or by the bones losing calcium.
True or False: Dehydration, infection, immobility, and obesity elevates the risk for a patient to create kidney stones.
True
What are the three things a patient can have excess of in their diet that can create kidney stones?
Calcium, oxalate and proteins.
If a patient lives in this type of climate they are less likely to create kidney stones.
Hot dry climate
If a patient is from this heritage they are less likely to create kidney stones.
Mediterranean
Why would pregnant women require special consideration in terms of kidney stones?
Because they already have a decrease of kidney function due to pregnancy.
What two races are more likely to create kidney stones?
Asians and Whites
Kidney stones are more likely to develop in children with what types to defects?
Defects in the urinary tract or with metabolic disorders.
The most important way to prevent kidney stones is
Adequate fluid intake
Calcium kidney stones can be prevented by doing what?
-Reducing sodium and animal protein intake -Limiting food high in calcium oxalate -Increasing food that acidify the urine
Uric acid stones can be prevented by doing what?
-limiting animal intake -low purine diet
What can patients with a history of kidney stones take to help prevent future stone formation?
Medications
Calculi affecting the kidney calyces and pelvis tend to have what kind of symptoms?
Very few
If a patient has bladder calculi they tend to have what kind of symptoms?
Dull suprapubic pain with exercise and voiding
If a urinary flow is gradually or partially obstructed what types of symptoms do patients have?
Dull, aching flank pain
True or False: Hematuria is not a symptom of kidney stones.
False: It is a symptom.
What is the number one thing that contributes to the formation of kidney stones?
Animal protein
What is always the major hallmark symptom of kidney stones?
Pain
A gradual obstruction means what?
That the stone is not very big but will continue to grow
An acute obstruction due to a kidney stone can lead to what?
Kidney failure
If a kidney stone obstructs the ureter this tends to lead to what?
-Ureteral spasm -Severe pain with accompanying sympathetic response.
What may accompany a urinary calculi?
UTI
How is hydronephrosis described?
The kidney continues to work but suddenly the urine is blocked.
What types of symptoms develop due to hydronephrosis?
-Colicky pain on affected side -Hematuria -UTI -GI symptoms
Urinary stasis associated with partial or complete obstruction increases the risk of what?
UTI
What happens during a cystoscopy?
A tube with a camera attached goes up into the ureter to see what is going on.
A CT scan with or without contrast can diagnose a kidney stone. What must you know before you do this diagnostic test?
If they are on metformin.
After the patient passes the kidney stone what do the doctors do with it?
They do a chemical analysis to see what it is made of.
How do you manage relieving acute symptoms of kidney stones?
-Hydration -Pain control -I&O
How can a patient prevent further stone formation?
Change of diet, exercise, and hydration.
After destroying or removing stones it is important for a patient and/or doctor to?
collect them for testing.
What is this method of treating kidney stones?
Cystoscopy
What is this method of treating kidney stones?
Extracorporeal shock wave lithotripsy
After an extracorporeal shock wave lithotripsy treatment what should the patient urine look like?
It should be clear and odorless
What is this method of treating kidney stones?
Percutaneous lithotripsy
What are the seven patient education topics that should be taught to a patient with kdiney stones?
- Signs and symptoms to report
- Follow up care
- Urine pH monitoring
- Measures to prevent recurrent stones
- Importance of fluid intake
- Dietary education
- Medication education as needed.
