Nursing 212

Health Differences Across the Lifespan 2 Study Guide

Peritoneal dialysis

Renal Calculi Renal Calculi (kidney stones) is a presence of stones. Stones formwhen chemicals and other elements in the urine become concentrated and form crystals, usually related to metabolic and dietary causes. Types of stones are calcium phosphate, oxalate, struvate, uric acid, and cysteine. Stones may be single or multiple and vary in size. Large calculi cause pressure necrosis and can also lead to obstruction. Risk factors include: • Dehydration • Infection (damaged tissue and changing pH provide an environment for calculi to develop) • Obstruction (urine stasis allows solid material to collect) • Hypoparathyroidism • Renal tubular acidosis • Elevated uric acid levels • Defective oxalatemetabolism • Excessive vitamin D or calciumintake Signs and symptoms include flank pain on the side of the kidney, which may radiate to the groin, and fluctuate in intensity, nausea, vomiting, fever, chills, and abdominal distension. Labs: urinalysis may reveal hematuria, pyuria, and crystal fragments; 24-hour urine levels for calcium, uric acid, and oxalate; serum levels of calcium, phosphorous, and uric acid; chemical analysis of stones passed for content and type; KUB, IVP, retrograde pyelography, renal ultrasound, CT scan, cystoscopy, and MRI; need to assess client for any allergy to shellfish oriodine

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