NURS 5335 VERIFIED MODULE 2 RENAL EXAM QUESTIONS AND
ANSWERS LATEST UPDATE
Urolithiasis, Nephrolithiasis description
Renal, endocrine, and metabolic disorders lead to the development of crystalized
material in the urinary system; stones in the urinary tract are generally calssified based
on the chemical compnonents: calcium, uric acid, cystine, magnesium, aluminum,
phsotpahte; urolithiasis is common cuae of blood in the urine and pain the abdomen,
flank, and groin
Urolithiasis, Nephrolithiasis etiology
-Supersaturation of urine with stone forming salts
-Presence of chemical or physical stimuli in urine that promote stone formation
-Inadequate number of urine compounds that inhibit stone formation
-Calcium, vitamin C, magnesium, and animal protein intake can increase risk
-Calcium oxalate/calcium phosphate are most common cause
Urolithiasis, Nephrolithiasis risk factors
-Renal tubular acidosis
-Alkaline pH of urine
-Cystinuria
-Genetic defects
-Low water intake or high vitamin C or D consumption
-Calcium supplementation
-Thiazide diuretic use, gout
-Diet high in animal protein
-Sedentary lifestyle
Urolithiasis, Nephrolithiasis assessment findings
-Sudden onset of back and flank pain that waxes and wanes
-Pain may radiate to groin, testicles, suprapubic area, and labia
-CVA tenderness
-Flank pain
-Hematuria
,-Dysuria
-Urinary frequency
-Diaphoresis
-Restlessness
-Tachycardia
-Tachypnea
-Chills and fever secondary to infection from obstruction
-N/V
Urolithiasis, Nephrolithiasis diagnostics
-UA
-CBC
-BUN, Cr, metabolic panel
-Urine culture: may be positive if obstruction
-24 hour urine collection for calcium, uric acid, mag, oxalate, citrate, and creatinine
-Spiral CT considered gold standard but is most expensive
-KUB xray
-Intravenous pyelogram
-US if CT annot be done due to radiation exposure or cost
Urolithiasis, Nephrolithiasis non-pharm treatment
-Diet low in animal fat
-Increased fiber in diet
-Fluid intake to maintain urine output of 2-3L/day
-Stain urine for presence of stones for 72 hours after symptoms resolve
Urolithiasis, Nephrolithiasis non-pharm treatment for stones >6mm
-Extracorporeal shock wave therapy
-Uteroscopy
-Percutaneous nephrolithotomy
-Open surgery for removal
Urolithiasis, Nephrolithiasis Calcium stone non-pharm treatment includes
restriction of
, -Protein
-Sodium
-Dairy
-Calcium rich foods
Urolithiasis, Nephrolithiasis Uric acid stone non-pharm treatment
Alkalinization of urine
Urolithiasis, Nephrolithiasis pharm treatment
-Narcotic analgesics or NSAIDs for pain
-Antiemetics if nausea present
-Tamulosin 0.4-0.8mg to assist with expulsion
Vesicoureteral reflux description
Is a condition in which urine travels backward from the bladder to the urters and kidneys
due to anatomoical or functional disorder
Vesicoureteral reflux primary
-Most common
-Usually unilateral
-Infant born with short ureter, valve malfunction
-Improves as child grows
Vesicoureteral reflux secondary
-Usually bilateral
-Incomplete uterovesical junction closure due to higher than normal bladder pressures
-This may be related to anatomical or mechanical dysfunction such as bladder outlet
obstruction, neurogenic bladder or posterior urethral valve malfunction
Vesicoureteral reflux Grade 1
Reflux fills nondilated ureter
Vesicoureteral reflux Grade 2
Reflux fills ureter and renal pelvis and calyces without dilation
Vesicoureteral reflux Grade 3
Reflux fills and mildly dilates the ureter, renal pelvis, and calyces
Vesicoureteral reflux Grade 4
ANSWERS LATEST UPDATE
Urolithiasis, Nephrolithiasis description
Renal, endocrine, and metabolic disorders lead to the development of crystalized
material in the urinary system; stones in the urinary tract are generally calssified based
on the chemical compnonents: calcium, uric acid, cystine, magnesium, aluminum,
phsotpahte; urolithiasis is common cuae of blood in the urine and pain the abdomen,
flank, and groin
Urolithiasis, Nephrolithiasis etiology
-Supersaturation of urine with stone forming salts
-Presence of chemical or physical stimuli in urine that promote stone formation
-Inadequate number of urine compounds that inhibit stone formation
-Calcium, vitamin C, magnesium, and animal protein intake can increase risk
-Calcium oxalate/calcium phosphate are most common cause
Urolithiasis, Nephrolithiasis risk factors
-Renal tubular acidosis
-Alkaline pH of urine
-Cystinuria
-Genetic defects
-Low water intake or high vitamin C or D consumption
-Calcium supplementation
-Thiazide diuretic use, gout
-Diet high in animal protein
-Sedentary lifestyle
Urolithiasis, Nephrolithiasis assessment findings
-Sudden onset of back and flank pain that waxes and wanes
-Pain may radiate to groin, testicles, suprapubic area, and labia
-CVA tenderness
-Flank pain
-Hematuria
,-Dysuria
-Urinary frequency
-Diaphoresis
-Restlessness
-Tachycardia
-Tachypnea
-Chills and fever secondary to infection from obstruction
-N/V
Urolithiasis, Nephrolithiasis diagnostics
-UA
-CBC
-BUN, Cr, metabolic panel
-Urine culture: may be positive if obstruction
-24 hour urine collection for calcium, uric acid, mag, oxalate, citrate, and creatinine
-Spiral CT considered gold standard but is most expensive
-KUB xray
-Intravenous pyelogram
-US if CT annot be done due to radiation exposure or cost
Urolithiasis, Nephrolithiasis non-pharm treatment
-Diet low in animal fat
-Increased fiber in diet
-Fluid intake to maintain urine output of 2-3L/day
-Stain urine for presence of stones for 72 hours after symptoms resolve
Urolithiasis, Nephrolithiasis non-pharm treatment for stones >6mm
-Extracorporeal shock wave therapy
-Uteroscopy
-Percutaneous nephrolithotomy
-Open surgery for removal
Urolithiasis, Nephrolithiasis Calcium stone non-pharm treatment includes
restriction of
, -Protein
-Sodium
-Dairy
-Calcium rich foods
Urolithiasis, Nephrolithiasis Uric acid stone non-pharm treatment
Alkalinization of urine
Urolithiasis, Nephrolithiasis pharm treatment
-Narcotic analgesics or NSAIDs for pain
-Antiemetics if nausea present
-Tamulosin 0.4-0.8mg to assist with expulsion
Vesicoureteral reflux description
Is a condition in which urine travels backward from the bladder to the urters and kidneys
due to anatomoical or functional disorder
Vesicoureteral reflux primary
-Most common
-Usually unilateral
-Infant born with short ureter, valve malfunction
-Improves as child grows
Vesicoureteral reflux secondary
-Usually bilateral
-Incomplete uterovesical junction closure due to higher than normal bladder pressures
-This may be related to anatomical or mechanical dysfunction such as bladder outlet
obstruction, neurogenic bladder or posterior urethral valve malfunction
Vesicoureteral reflux Grade 1
Reflux fills nondilated ureter
Vesicoureteral reflux Grade 2
Reflux fills ureter and renal pelvis and calyces without dilation
Vesicoureteral reflux Grade 3
Reflux fills and mildly dilates the ureter, renal pelvis, and calyces
Vesicoureteral reflux Grade 4
