Questions on Kidney Stones PDF

1. What procedure is used to remove stones from the ureter? - Ureterolithotomy 2. What procedure is used to remove stones from the bladder? - Cystotomy 3. What is the procedure called when a stone in the bladder is crushed using an instrument inserted through the urethra? - Cystolitholapaxy 4. Wh...

1. What procedure is used to remove stones from the ureter? - Ureterolithotomy 2. What procedure is used to remove stones from the bladder? - Cystotomy 3. What is the procedure called when a stone in the bladder is crushed using an instrument inserted through the urethra? - Cystolitholapaxy 4. What are the signs and symptoms of a urinary tract infection (UTI)? - Chills, fever, frequency, hesitancy 5. What are the signs and symptoms of urinary tract obstruction? - Frequent urination of small amounts, oliguria, anuria 6. What should be done with the patient's urine to check for stones or gravel? - It should be strained 7. What are the potential complications of kidney stones? - Infection, urosepsis, obstruction 8. What are the nursing diagnoses for a patient with renal calculi? - Acute pain, lack of knowledge regarding prevention of recurrence 9. What are the major goals for a patient with kidney stones? - Relief of pain, prevention of recurrence, absence of complications 10. How can severe acute pain in a patient with kidney stones be relieved? - Opioid analgesic agents and IV NSAID may be used 11. How can fluid intake help manage kidney stones? - It prevents dehydration and increases hydrostatic pressure to promote stone passage 12. What should be done if a patient with kidney stones passes blood clots in their urine? - The clots should be crushed and the urine and bedpan inspected for clinging calculi 13. What should a patient with kidney stones report to the primary provider? - Decreased urine volume, bloody or cloudy urine, fever, and pain 14. Why should a sudden increase in pain intensity be reported by a patient with kidney stones? - It could indicate a stone fragment obstructing a ureter 15. What should be monitored to detect early signs of infection in a patient with kidney stones? - Vital signs, including temperature 16. What should be treated before attempting to dissolve a kidney stone? - Any associated infections with appropriate antibiotics 17. What are the goals of management for renal or ureteral colic? - The goals of management are to eradicate the stone, determine the stone type, prevent nephron destruction, control infection, and relieve any obstruction that may be present. 18. What is the immediate objective of treatment for renal or ureteral colic? - The immediate objective of treatment is to relieve the pain until its cause can be eliminated. 19. Why are opioid analgesic agents given for renal or ureteral colic? - Opioid analgesic agents are given to prevent shock and syncope that may result from the excruciating pain. 20. What is the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in treating renal calculus pain? - NSAIDs provide specific pain relief and inhibit the synthesis of prostaglandin E, reducing swelling and facilitating passage of the stone. 21. What is the recommended fluid intake for patients with renal calculi? - Patients with renal calculi should drink eight to ten 8-oz glasses of water daily or have IV fluids prescribed to keep the urine dilute. 22. What is the mainstay of most medical therapy for renal calculi? - Fluid intake is the mainstay of most medical therapy for renal calculi. 23. What is the recommended urine output for patients with renal calculi? - A urine output exceeding 2 L/day is advisable. 24. What dietary recommendation is given for patients with calcium stones? - Historically, patients with calcium-based renal calculi were advised to restrict calcium in their diet, except for patients with type 2 absorptive hypercalciuria. 25. What is the recommended nutritional therapy for patients with uric acid stones? - For uric acid stones, the patient is placed on a low-purine diet to reduce the excretion of uric acid in the urine. 26. What foods should be avoided in a low-purine diet for uric acid stones? - Foods high in purine (shellfish, anchovies, asparagus, mushrooms, and organ meats) should be avoided. 27. What medication may be prescribed for patients with uric acid stones? - Allopurinol may be prescribed to reduce serum uric acid levels and urinary uric acid excretion, and to dissolve or reduce the size of existing stones. 28. What measures are recommended for patients with cystine stones? - For cystine stones, a low-protein diet may be prescribed, the urine is alkalinized with potassium alkali salts, and fluid intake is increased. 29. How is a dilute urine maintained for patients with oxalate stones? - A dilute urine is maintained through increasing fluid intake, and the intake of oxalate is limited. 30. What are some foods high in oxalate that should be limited for patients with oxalate stones? - Foods such as spinach, Swiss chard, chocolate, peanuts, and pecans contain oxalate and should be limited. 31. What interventional procedures may be necessary if a stone does not pass spontaneously or complications occur? - Common interventions include endoscopic or other procedures like ureteroscopy, ESWL, or endourologic stone removal. 32. What is the purpose of a stent in ureteroscopy? - A stent may be inserted and left in place for 48 hours or more after the procedure to keep the ureter patent. 33. What factors should be considered for patients with calcium stones to reduce calcium loss in urine? - If increased parathormone production is a factor, therapy with thiazide diuretics may be beneficial in reducing calcium loss in the urine and lowering the elevated parathormone levels. 34. What is the length of hospital stay generally like for interventional procedures to treat urinary stones? - The length of hospital stay is generally brief. 35. What is ESWL? - ESWL, or lithotripsy, is a noninvasive procedure used to break up kidney stones using shock waves. 36. How are kidney stones fragmented in ESWL? - A high-energy amplitude of pressure, or shock wave, is generated and transmitted through water and soft tissues, causing the surface of the stone to fragment. 37. What happens to the remnants of the fragmented stones in ESWL? - The remnants of the stones are spontaneously voided in the urine. 38. What are the potential complications of ESWL? - Hemorrhage, infection, and urinary extravasation are the most common complications. 39. What is the purpose of straining all urine after ESWL? - To collect any voided gravel or sand for chemical analysis in the laboratory. 40. What are the endourologic methods of kidney stone removal? - Percutaneous nephrostomy and percutaneous nephrolithotomy are commonly used methods. 41. How is a large kidney stone removed using endourologic methods? - If the stone is too large, an ultrasound probe is used to pulverize the stone, and the fragments are then removed. 42. What is electrohydraulic lithotripsy? - It is a method where an electrical discharge creates a hydraulic shock wave to break up the stone. 43. What are the potential complications of surgical management for kidney stones? - Anatomic abnormalities within the kidney, hemorrhage, infection, and urinary extravasation. 44. What surgical procedures may be performed if noninvasive methods fail to treat kidney stones? - Nephrolithotomy or nephrectomy may be performed depending on the condition of the kidney. 45. What is chemolysis? - It is a treatment method that involves stone dissolution using infusions of chemical solutions. 46. When is chemolysis used as a treatment for kidney stones? - Chemolysis is used in patients at risk for complications with other methods or for stones that dissolve easily. 47. What is monitored during chemolysis? - The pressure inside the renal pelvis is monitored during the procedure. 48. What are the alternative treatment modalities used in combination for kidney stone removal? - ESWL, endourologic methods, and chemolysis may be used in combination. 49. What type of surgical intervention may be performed if the kidney stone does not respond to other treatments? - Nephrolithotomy or nephrectomy may be performed to remove the stone. 50. How are stones in the kidney pelvis removed? - Stones in the kidney pelvis are removed by pyelolithotomy surgery. 51. What are some recommendations to prevent the recurrence of renal calculi? - Avoid protein intake, limit sodium intake, avoid oxalate-containing foods, drink fluids regularly, and avoid sudden increases in environmental temperatures. 52. Why are low-calcium diets not generally recommended to prevent renal calculi? - Limiting calcium can lead to osteoporosis and does not prevent calculi. 53. How often should urine cultures be performed in the first year for a patient with recurrent UTI? - Every 1 to 2 months. 54. How does prolonged immobilization affect renal drainage and calcium metabolism? - It slows renal drainage and alters calcium metabolism. 55. What complications should a patient with a history of stone removal procedures report to the primary provider? - Urinary retention, infection, and any signs or symptoms of complications. 56. Why is follow-up care important after lithotripsy or other stone removal procedures? - To assess kidney function and ensure the eradication or removal of all renal calculi. 57. What is the expected duration of passage of stone fragments after undergoing ESWL? - 6 weeks to several months. 58. What should a patient with a stent in the ureter expect regarding hematuria? - Hematuria may be expected until the stent is removed. 59. What temperature should a patient monitor daily after stone removal procedures? - If the temperature exceeds 38°C (about 101°F), they should notify the primary provider. 60. What is an anticipated side effect of ESWL treatment? - Hematuria, which should disappear within 4 to 5 days. 61. What should a patient do if the pain after a stone removal procedure is unrelieved by prescribed medication? - They should notify the primary provider. 62. What should a patient expect to observe on the treated side of the back after ESWL treatment? - A bruise. 63. Why is close monitoring of the patient in follow-up care essential after stone removal procedures? - To ensure treatment effectiveness and monitor for any complications. 64. What opportunity does the nurse have during follow-up care? - To assess the patient's understanding of ESWL and possible complications. 65. What opportunity does the nurse have in relation to assessing the patient with renal calculi? - The nurse has the opportunity to assess the patient's understanding of factors that increase the risk of recurrence of renal calculi and strategies to reduce those risks. 66. What does the nurse need to assess in relation to the patient with renal calculi during follow-up visits? - The nurse needs to assess the patient's ability to monitor urinary pH and interpret the results during follow-up visits. 67. Why does the patient with renal calculi need to understand the signs and symptoms of stone formation, obstruction, and infection? - The patient needs to understand the signs and symptoms of stone formation, obstruction, and infection to report them promptly. 68. What does the nurse explain to the patient if medications are prescribed for the prevention of stone formation? - The nurse explains the actions, importance, and side effects of the medications to the patient.