Chapter 55 Pages 15911596 By Heather Wacholz BSNRNCCRNCMCCNRN Normal Kidney Function Kidney Stones Kidney stones renal Urolithiasis or nephrolithiasis are small hard mineral deposits that form inside your kidneys The stones are made of mineral and acid salts ID: 561571
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Kidney stones
Chapter 55
Pages 1591-1596
By: Heather Wacholz BSN,RN,CCRN-CMC,CNRNSlide2
Normal Kidney Function Slide3
Kidney Stones
Kidney stones (renal
Urolithiasis or
nephrolithiasis) are small, hard mineral deposits that form inside your kidneys. The stones are made of mineral and acid salts.
Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.
Passing kidney stones can be quite painful, but the stones usually cause no permanent damage. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract or cause complications — surgery may be neededSlide4
Picture of Kidney StoneSlide5
More PicturesSlide6
Kidney Stone
50% of patients with a single renal stone will develop another within five years
Stones are usually formed in the urinary tract
Concentrations of substances such as calcium oxalate, calcium phosphate, and uric acid increase
Stones may be found in the kidney, ureters, and/or bladderSlide7
Pathophysiology
Stone formation is not clearly understood
One theory is there is a deficiency of substances that normally prevent crystallization in the urine
For example, citrate, Mg., Nephrocalcin, and
U
ropontin
Dehydration
Immobility
infectionSlide8
Pathophysiology Continued
Cancer
Excessive Vitamin D
Excess milk and alkali
Polycythemia Vera
Hyperparathyroidism
Renal tubular acidosisSlide9
Types of Stones
Calcium
Uric Acid
Cystine
OxalateSlide10
Clinical Manifestations
Infection (Bladder)
Pain
Hematuria
Pain over the costovertebral area
Nausea and Vomiting
Stone in the ureter cause colicky painSlide11
Diagnostics
KUB
Ultrasonography
IV urography
Retrograde Pyelography
Blood Chemistries
24 Hour urineSlide12
X-ray of a Kidney StoneSlide13
Medical Management
Eradicate the Stone
Prevent nephron destruction
Control infection
Relive obstruction that may be present
Opioid analgesic
NSAIDS
Hot Baths
Moist heat
Increase PO intake (2 L/day)Slide14
Surgical Management
Surgery 1-2% of patients
Nephrolithotomy
Nephrectomy
UreteroscopySlide15
UreteroscopySlide16
Nursing Care Plan
Acute Pain
Deficient knowledge
Infection/Urosepsis
Major goals include relief of pain and prevention of reoccurrence
Absence of complications