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NR 570 Final Exam Study Guide.pdf
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NR 570 Final Exam Study GuideWhat is nephrolithiasis? –answer renal calculi (kidney stones)
How does Renal calculi form? - answer formed d/t elevated levels of minerals in the
body
What minerals in excess can cause renal calculi? - answer calcium oxalate (most
common),
phosphate
uric acid
struvite
cystine
Urolithiasis - answer stone in the bladder
Ureterolithiasis - answer condition of stones in the ureter
,Risk Factor & complications of renal calculi - answer -Male, 20-50yo, previous stones,
obesity, HTN, diabetes, low fluid intake.
-complications of stones: obstructions, pyelonephritis (kidney infection), CKD
Classic Kidney stone presentation - 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) - 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? - 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? answer - pain that
radiates downward into the groin indicates the stone has passed into the lower third of
the ureter
Vague flank pain or acute colicky pain with increasing intensity means the stone is
located where? answer - stones in renal pelvis
Differential Diagnosis for abdominal pain and/or flank pain: 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? -
Blumberg sign: Rebound tenderness in the RLQ, caused by acute peritonitis.
*Appendicitis
What labs do we run to diagnose a kidney stone? - 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 - 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 - CAN see: Calcium oxalate - answer most
common type of stone
CANNOT see: uric acid stones (radio translucent)
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