NR 570 Final Exam Study Guide
What is nephrolithiasis? - correct answer renal calculi (kidney stones)
How does Renal calculi form? - correct answer formed d/t elevated levels of minerals in the
body
What minerals in excess can cause renal calculi? - correct answer calcium oxalate (most
common),
phosphate
uric acid
struvite
cystine
Urolithiasis - correct answer stone in the bladder
Ureterolithiasis - correct answer condition of stones in the ureter
Risk Factor & complications of renal calculi - correct answer -Male, 20-50yo, previous stones,
obesity, HTN, diabetes, low fluid intake.
-complications of stones: obstructions, pyelonephritis (kidney infection), CKD
Classic Kidney stone presentation - correct answer acute onset of severe, colicky flank pain
that wax and wane in intensity.
Severe pain is associated with the movement of the stone and can cause n/v.
pt may seem anxious and unable to sit still
history and physical for nephrolithiasis (kidney stones) - correct answer Irritative Bladder
symptoms -dysuria (painful or difficulty urinating), urgency, & frequency
Vague flank pain or acute colicky pain with increasing intensity
Radiation of pain into the groin
Costovertebral angle (CVA) tenderness
Hematuria
Diaphoretic, tachycardic, appear extremely uncomfortable
CVA tenderness tell your the stone is located where? - correct answer caused by passing of the
stone through the ureter with obstruction & spasm
Where is the stone located if the patient has pain in the groin region? - correct answer pain
that radiates downward into the groin indicates the stone has passed into the lower third of the
ureter
,NR 570 Final Exam Study Guide
Vague flank pain or acute colicky pain with increasing intensity means the stone is located
where? - correct answer stones in renal pelvis
Differential Diagnosis for abdominal pain and/or flank pain: - correct answer Nephrolithiasis
(kidney stones)
Pyelonephritis (kidney infection)
Ectopic pregnancy
Ovarian or testicular torsion
Appendicitis
Bowel obstruction
Diverticulitis
Rupture of aortic aneurysm
Right lower abdominal tenderness with a +Blumberg sign. What should be suspected? - correct
answer Blumberg sign: Rebound tenderness in the RLQ, caused by acute peritonitis.
*Appendicitis
What labs do we run to diagnose a kidney stone? - correct answer UA dipstick, urine
microscopy and urine C&S
Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
What radiology methods are preferred for outpatient treatment and why - correct answer
inexpensive, easily accessible. in combo its more practical
-KUB xray
-Renal Ultrasound
What stones can be seen on a KUB?
What stone can you not see on a KUB - correct answer CAN see: Calcium oxalate - most
common type of stone
CANNOT see: uric acid stones (radio translucent)
What is a Renal Ultrasound used for when testing for kidney stones? - correct answer good for
assessing for hydronephrosis (excess fluid in the kidney d/t back up of urine that can be caused
by an obstruction). Bad for identifying a stone.
What is the GOLD STANDARD for diagnosing a kidney stone? - correct answer Non-contrast CT
scan.
, NR 570 Final Exam Study Guide
Goal of renal calculi treatment - correct answer focused on symptomatic relief
pain medications -NSAID or narcs
antiemetics -n/v
facilitate stone passage-Thiazide diuretics, alpha-blockers or calcium channel blockers to help
facilitate the passage of a stone. Terazosin -alpha blockers used for BPH.
<5 mm renal calculi can - correct answer be passed through the urine. may only require NSAIDs
for management.
>5 mm renal calculi requires what? - correct answer urology consult.
this may cause an obstruction or kidney failure.
this type of stone may need surgical intervention to be removed.
when is a Urology Referral indicated? - correct answer stone > 5mm
recurrent stones
When is a hospital admission appropriates for a patient with nephrolithiasis? - correct answer
Hospital admission is indicated when:
-Inability to control pain
-Impaired renal function with an obstructing stone
-Infection (pyelonephritis or sepsis)
-Intractable n/v
What does a 24 hour urine collection analyze? - correct answer -total volume
-urine pH
-calcium oxalate
-uric acid
-citrate
-sodium
-potassium
-creatinine
Factor Regarding hospital DC for nephrolithiasis - correct answer -Pain is reasonably controlled
-n/v controlled
What is nephrolithiasis? - correct answer renal calculi (kidney stones)
How does Renal calculi form? - correct answer formed d/t elevated levels of minerals in the
body
What minerals in excess can cause renal calculi? - correct answer calcium oxalate (most
common),
phosphate
uric acid
struvite
cystine
Urolithiasis - correct answer stone in the bladder
Ureterolithiasis - correct answer condition of stones in the ureter
Risk Factor & complications of renal calculi - correct answer -Male, 20-50yo, previous stones,
obesity, HTN, diabetes, low fluid intake.
-complications of stones: obstructions, pyelonephritis (kidney infection), CKD
Classic Kidney stone presentation - correct answer acute onset of severe, colicky flank pain
that wax and wane in intensity.
Severe pain is associated with the movement of the stone and can cause n/v.
pt may seem anxious and unable to sit still
history and physical for nephrolithiasis (kidney stones) - correct answer Irritative Bladder
symptoms -dysuria (painful or difficulty urinating), urgency, & frequency
Vague flank pain or acute colicky pain with increasing intensity
Radiation of pain into the groin
Costovertebral angle (CVA) tenderness
Hematuria
Diaphoretic, tachycardic, appear extremely uncomfortable
CVA tenderness tell your the stone is located where? - correct answer caused by passing of the
stone through the ureter with obstruction & spasm
Where is the stone located if the patient has pain in the groin region? - correct answer pain
that radiates downward into the groin indicates the stone has passed into the lower third of the
ureter
,NR 570 Final Exam Study Guide
Vague flank pain or acute colicky pain with increasing intensity means the stone is located
where? - correct answer stones in renal pelvis
Differential Diagnosis for abdominal pain and/or flank pain: - correct answer Nephrolithiasis
(kidney stones)
Pyelonephritis (kidney infection)
Ectopic pregnancy
Ovarian or testicular torsion
Appendicitis
Bowel obstruction
Diverticulitis
Rupture of aortic aneurysm
Right lower abdominal tenderness with a +Blumberg sign. What should be suspected? - correct
answer Blumberg sign: Rebound tenderness in the RLQ, caused by acute peritonitis.
*Appendicitis
What labs do we run to diagnose a kidney stone? - correct answer UA dipstick, urine
microscopy and urine C&S
Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
What radiology methods are preferred for outpatient treatment and why - correct answer
inexpensive, easily accessible. in combo its more practical
-KUB xray
-Renal Ultrasound
What stones can be seen on a KUB?
What stone can you not see on a KUB - correct answer CAN see: Calcium oxalate - most
common type of stone
CANNOT see: uric acid stones (radio translucent)
What is a Renal Ultrasound used for when testing for kidney stones? - correct answer good for
assessing for hydronephrosis (excess fluid in the kidney d/t back up of urine that can be caused
by an obstruction). Bad for identifying a stone.
What is the GOLD STANDARD for diagnosing a kidney stone? - correct answer Non-contrast CT
scan.
, NR 570 Final Exam Study Guide
Goal of renal calculi treatment - correct answer focused on symptomatic relief
pain medications -NSAID or narcs
antiemetics -n/v
facilitate stone passage-Thiazide diuretics, alpha-blockers or calcium channel blockers to help
facilitate the passage of a stone. Terazosin -alpha blockers used for BPH.
<5 mm renal calculi can - correct answer be passed through the urine. may only require NSAIDs
for management.
>5 mm renal calculi requires what? - correct answer urology consult.
this may cause an obstruction or kidney failure.
this type of stone may need surgical intervention to be removed.
when is a Urology Referral indicated? - correct answer stone > 5mm
recurrent stones
When is a hospital admission appropriates for a patient with nephrolithiasis? - correct answer
Hospital admission is indicated when:
-Inability to control pain
-Impaired renal function with an obstructing stone
-Infection (pyelonephritis or sepsis)
-Intractable n/v
What does a 24 hour urine collection analyze? - correct answer -total volume
-urine pH
-calcium oxalate
-uric acid
-citrate
-sodium
-potassium
-creatinine
Factor Regarding hospital DC for nephrolithiasis - correct answer -Pain is reasonably controlled
-n/v controlled
