Wk 3 Nephrolithiasis Flashcards
What is the medical term for kidney stones?
nephrolithiasis
Lithos =
stone
Calculi =
something accidental that doesn’t belong in the body
What 4 parts of the urinary system can become obstructed?
Urethra
Bladder
Ureters
Kidneys
Where in the kidneys does an obstruction typically occur?
Renal pelvis where urine gets collected and drained to the ureters
The complete an occlusion the more…
destruction can occur
The closer the occlusion is to the kidneys…
the more damage can be done to the kidneys
What an a reason a man might have back flow into the bladder?
An occlusion caused by an enlarged prostate
The longer the blockage has been there the…
more damage and inflammation
What would an occlusion in the renal pelvis be caused by?
Renal calculi
What 3 reasons would cause an occlusion in the ureter?
Renal calculi
Pregnancy
Tumors
What are renal calculi?
Kidney stones
What causes the severe pain associated with kidney stones?
When the stones move, especially in the ureter
Why is pregnancy a possible reason for an occlusion of the ureter?
A large fetus in a certain position can obstruct the ureter
5 reasons for an obstruction of the bladder and urethra
Bladder cancer Neurogenic bladder Prostatic hyperplasia Prostate cancer Urethral strictures
What are urethral strictures?
Scarring that narrows the urethra
What is neurogenic bladder?
A condition in which problems with the nervous system affect the bladder and urination
What can cause neurogenic bladder?
Conditions like stoke, Parkinson’s disease, spinal injuries
What might cause urethral strictures?
Repeated catheterizations, for example someone with neurogenic bladder who has to repeat cath themselves
What is a potential complication of an occlusion?
Stasis of urine flow
What is the problem with urine stasis?
Puts the patient at risk for infection
What are three complications of back-up pressure?
Hydroureter
Hydronephrosis
Postrenal acute kidney injury
What is hydroureter?
Dilation of the ureter due to obstruction of urine outflow
What is hydronephrosis?
Swelling of one or both kidneys
What is post acute kidney injury?
When an obstruction in the urinary tract below the kidneys causes waste to build up in the kidneys
If there is an obstruction in the renal pelvis, will there be as much pain as the ureter?
No because there is more room for a stone
Manifestations of an acute obstruction depends on which three factors?
Site
Cause (ex: kidney sontes, prostate problems)
Speed of onset
Which factor primarily determines the severity of pain?
Site, is the site large enough for the blockage?
What is the definition of nephrolithiasis?
Crystals form in the urinary tract and form a stone-like object
Where do these crystals form?
In the renal pelvis
Who is at higher risk for kidney stones, men or women?
Men
What age range is typical for kidney stones?
20s-30s
What race is more prone to kidney stones?
White
What effect does weather have on the risk of developing kidney stones?
Hot weather can cause dehydration, urine is more concentrated and stays longer in the body and initiates form of crystals
What are two other risk factors for kidney stones?
Family history
Obesity
The etiology of nephrolithiasis (the stones themselves) depend on what three factors?
Individual risk factors
Characteristics of the urine (diet, medications)
Type of stone being formed
What are the three types of kidney stones?
Calcium oxalate
Struvite “Staghorn”
Uric acid
75% of stones formed in the urinary tract are what type?
Calcium oxalate
What are four reasons a patient might develop calcium oxalate kidney stones?
Family history
Idiopathic
Hypercalcemia
Hyperoxaluria
What is hyperoxaluria?
Too much oxalate in your urine
What is oxalate?
A waste product produced by the body and excreted in the urine
What is hypercalcemia?
High calcium in the blood
Why is a struvite kidney stone called a “Staghorn”?
It takes on the shape of the renal pelvis, resembles horns
What is a risk factor for developing a struvite kidney stone?
UTIs
How does a UTI cause a struvite kidney stone?
Bacteria breaking down products in the urine
What is a risk factor for a uric acid kidney stone?
Gout
How do the crystals form in urine?
When urine becomes super saturated with solutes, crystals begin forming in the nephron
What two factors enhance crystal formation?
Dehydration
Immobility/sedentary lifestyle
How does a struvite kidney stone exit the body?
They are often too large to pass and must be surgically removed
What is acute renal colic?
A wave-like flank pain that comes and goes as the ureter is trying to pass the kidney stone
Where is the location of acute renal colic?
It starts along the flank and move down towards the groin
What are 4 descriptor words of acute renal colic?
Radiation
Spasms
Intermittent
Sharp
What are the 5 accompanying symptoms of acute renal colic?
Nausea Vomiting Diaphoresis Tachycardia Tachypnea
Patients experiencing acute renal colic may avoid…
taking deep breaths because it intensifies the pain
What drugs are given for the acute pain of kidney stones?
Morphine or NSAIDs
IV fluids
Why do we give kidney stone patients IV fluids?
Dilute the urine, especially if they have poor PO intake due to nausea and vomiting
What is a preventative medication for a patient who experienced recurrent calcium oxalate stones?
Thiazide diuretics
What is a preventative medication for a patient who experiences recurrent struvite kidney stones?
Antibiotics
What is a preventative medication for a patient who experiences recurrent urate kidney stones?
Allopurinol
Why is allopurinol given to patients with uric acid kidney stones?
It’s given to treat gout, but also decreases the amount of uric acid in the body
Why are antibiotics given to a patient who gets struvite kidney stones?
The bacteria is what is causing these stones to form, antibiotics will rid of the bacteria
