Causes
Clinical Manifestations
Management
Prevention
MISC
100
Milk, Dairy products, Legumes, and Dried Fruit are linked to which type of stone?
Calcium-containing stones
100
Name at least 2 clinical manifestations of renal calculi.
Severe abdominal pain, flank pain, hematuria, renal colic
100
What is the name of the procedure that is used to eliminate calculi from the urinary tract?
Lithotripsy
100
Name 2 things a client can do to prevent renal calculi.
Change diet, change sedentary lifestyle
100
What are the 5 categories of stones?
Calcium phosphate, Calcium oxalate, Uric acid, Cystine, and Struvite
200
Uric Acid Stones are increased by which type of foods that increase purine and uric acid levels?
Organ meats and fish (sardines)
200
Which type of stone is more common in women than men due to UTIs?
Struvite stones
200
Name at least 3 of the 7 ways you can diagnose renal calculi.
Urinalysis, Urine culture, CT scan, IVP, Retrograde pyleogram, Ultrasound, and Cystoscopy
200
Since UTI can result from renal calculi...what are some signs and symptoms of UTI that the patient should recognize?
burning with urination, frequency and urgency, pain in bladder, bladder spasms, post-void pain, pelvic pain
200
Explain why climate would have anything to do with renal calculi formation.
Warm climates that cause increased fluid loss, low urine volume, and increased solute concentration in urine
300
Name at least 4 of the 6 risk factor categories that can cause kidney stones
Metabolic, Dietary, Genetic, Climatic, Lifestyle, Occupation
300
A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing severe flank pain and nausea; the temperature is 100.6 deg F. Which of the following would be a priority outcome for this client? a. Prevention of urinary tract complications b. Alleviation of nausea c. Alleviation of pain d. Maintenance of fluid and electrolyte balance
c. Alleviation of pain
300
What is one of the most important things to do after a patient has had a lithotripsy to treat renal calculi?
Measure urine output
300
What may selected patients be taught to self-monitor when sent home?
straining urine, urine pH, and urinary output
300
Stones larger than ____ mm are unlikely to pass through the ureter and may require lithotripsy or a stent placement.
4
400
Name 2 additional factors that are known to cause renal calculi.
Urinary stasis and UTI
400
What are the 2 common sites of obstruction?
1. the Ureteropelvic Junction (UPJ) - the point where the ureter crosses the iliac vessels 2. the Ureterovesical Junction
400
A client has renal colic due to renal lithiasis. What is the nurse's first priority in managing care for this client? a. Do not allow the client to ingest fluids b. Encourage the client to drink at least 500mL of water each hour c. Request the central supply department to send supplies for straining urine d. Administer an opioid analgesic as prescribed
d. Administer an opioid analgesic as prescribed
400
Which of the following interventions would be the most appropriate for preventing the development of a paralytic ileus in a client who has undergone renal surgery? a. Encourage the client to ambulate every 2 to 4 hrs b. Offer 3 to 4 oz of a carbonated beverage periodically c. Encourage use of a stool softener d. Continue IV fluid therapy
a. Encourage the client to ambulate every 2 to 4 hrs
400
It is estimated that _____________ people in the U.S. have nephrolithiasis (kidney stone disease).
500,000
500
Because a client's renal stone was found to be composed of uric acid, a low-purine, alkaline-ash diet was prescribed. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications? a. Milk, apples, tomatoes, and corn b. Eggs, spinach, dried peas, and gravy c. Salmon, chicken, caviar, and asparagus d. Grapes, corn, cereals, and liver
a. Milk, apples, tomatoes, and corn
500
In addition to nausea and severe flank pain, a female client with renal calculi has pain in the groin and bladder. The nurse should assess the client further for signs of: a. Nephritis b. Referred pain c. Urine retention d. Additional stone formation
b. referred pain
500
After an intravenous pyelogram (IVP), the nurse should anticipate incorporating which of the following measures into the client's plan of care? a. Maintaining bed rest b. Encouraging adequate fluid intake c. Assessing for hematuria d. Administering a laxative
b. Encouraging adequate fluid intake
500
A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan? a. Increase daily fluid intake to at least 2 to 3L b. Strain urine at home regularly c. Eliminate dairy products from the diet d. Follow measures to alkalinize the urine
a. Increase daily fluid intake to at least 2 to 3L
500
Allopurinol (Zyloprim), 200 mg/day, is prescribed for the client with renal calculi to take at home. The nurse should teach the client about which of the following adverse effects of this medication? a. Retinopathy b. Maculopapular rash c. Nasal congestion d. Dizziness
b. Maculopapular rash
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