NR 570 Final Exam Study Guide Latest Update

NR 570 Final Exam Study Guide Latest Update

• 170 Questions and 100%

Verified Correct Answers Guaranteed A+ Verified by Professor

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 1 / 4

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

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

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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.

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. 3 / 4

<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

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