• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/88

Click to flip

88 Cards in this Set

  • Front
  • Back
What is the length of the urethra in Men? In Women?
Men: 8 inches, 20 cm
Women 1.5 inches 3-5 cm
Where is the infection with cystitis
Inflammation of the urinary bladder
Where is the infection with pyleonephritis
Inflammation of the kidney and renal pelvis
What are some symptoms of urinary tract infection in the elderly?
1. Nocturia
2. Incontinence
3. Confusion
4. Behavior Change
5. Lethargy
6. Not feelng right
What are the signs and symptoms of acute pyleonephritis?
Rapid onset chills and fever, malaise, vomiting, flank pain, costovertebral tenderness, urinary frequency and dysureia, cystitis symptoms
What is the length of the urethra in Men? In Women?
Men: 8 inches, 20 cm
Women 1.5 inches 3-5 cm
Where is the infection with cystitis
Inflammation of the urinary bladder
Where is the infection with pyleonephritis
Inflammation of the kidney and renal pelvis
What are some symptoms of urinary tract infection in the elderly?
1. Nocturia
2. Incontinence
3. Confusion
4. Behavior Change
5. Lethargy
6. Not feelng right
What are the signs and symptoms of acute pyleonephritis?
Rapid onset chills and fever, malaise, vomiting, flank pain, costovertebral tenderness, urinary frequency and dysureia, cystitis symptoms
What diagnostic tests are used for Urinary Tract infections
1. Urinalysis
2. Gram Stain of urine
3. Culture and Sensitivity
4. WBC with differential
Describe the procedure for an IVP and identify teaching points for preparing a patient for an IVP
Procedure: An intravenous contrast medium is injected and passes through the blood stream into the kidneys so that their calices, pelvises, ureters, and bladder can be evaluated and structural or functional abnormalities can be seen. Xrays are used. Test takes 30 minutes
Teaching: A laxative enema may be used before the test to clear bowel. Do not eat the evening before the test. Drink fluids: water, coffee, or tea (no creamer).
When the dye is injected you will feel a flushing and burning sensation, maybe some nausea, and a metallic taste. Notify the Dr. if you see a rash. Increase fluid intake after the test
What medications are used for most patients with UTIs
Antibiotics that are sensitive to the infection
Cipro, Floxin
TMP-SMZ
What teaching points should be made to prevent UTIs
Wipe from front to back, drink fluids, especially water (2-2.5 quarts per day).
When you feel like you need to use the restroom, don’t hold it for long periods of time. Empty bladder at least every 3-4 hours unless sleeping.
Void after sex
Avoid bubble baths.
Define urinary calculi
Stones in the urinary tract-Most common cause of upper urinary tract obstruction. Leads to hydronephrosis. Decreased output & flank pain are the signs and symptoms.
Define urolithiasis
Stone formation in urinary tract.
AKA kidney stones
Define nephrolithiasis
Stone formation in the kidneys
Identify 4 types of (content of ) urinary calculi
Calcium Phosphate and or oxalate 75-80%
Sturvite 15-20%
Uric Acid 5%-10%
Cystine
What symptoms does a person experience with renal colic
Pain radiating to the suprapubic region. Groin and external genitals
Nausea/Vomiting, pallor and cool, clammy skin
What laboratory and diagnostic tests are appropriate for a patient with renal calculi
Urinalysis to assess for hematuria, and possible presence of WBCs and crystal fragments. Chemical analysis of any stones, urine calcium, uric acid, and oxalate serum calcium, phosphorus.
Diagnostic: KUB, IVP, CT, Renal ultrasonography
What meds may be used to treat the patient with renal calculi
Analgesics and hydration, A narcotic analgesic such as morphine sulfate is given. Indomethacin, a nonsteroidal anti-inflammatory drug, NSAID s given as a suppository so you might be able to take less analgesics
What dietary interventions are appropriate for patients with different types of stones.
Increase fluid intake to 2.5-3.0L spread throughout the day and evening.
Decrease intake of calcium and vitamin D
Uric acid stones-organ meats such as sardines and other high purine foods red and white meats, some seafoods may be limited. Eat foods that alkalinize the urine.
What are the indications for surgical intervention and removal of the stone?
Depends on the location of the stone and the extent of obstruction, renal function, the presence or absence of UTI, and the clients general state of health. The stone is removed if it is causing severe obstruction, infection, unrelieved pain, serious bleeding
What types of surgical procedures may be done for the removal of calculi
Lithotripsy using sound or shock waves to crush a stone is the preferred treatment for urinary calculi. Extracorporeal shock wave, lithotripsy, ureterolithotomy, pyelolithotomy
What are the major nursing concerns or diagnoses for a patient with urinary calculi
Pain-Acute
Impaired urinary elimination
Deficient knowledge
What part of the urinary tract is the most common site of urinary tract tumors
Painless hematuria, UTI, frequency, urgency, dysuria, colicky pain
What laboratory and diagnostic tests are used to diagnose urinary tumors
Urinalysis, urine cytology
What are the most common types of treatment for bladder tumors
Treatment: Simple resection of non invasive tumors to removal of the bladder and surrounding structures,
Transurethral tumor resection
Laser photocoagulation
Cystectomy urinary diversion
What nursing diagnoses are appropriate in pre and post op care for someone having surgery to remove bladder tumors
Impaired urinary elimination
Disturbed body image
Risk for impaired skin integrity
Risk for infection
Identify two types of neurogenic bladder
Spastic bladder dysfunction
Flaccid Bladder dysfunction
Identify laboratory and diagnostic tests used to diagnose/identify neurogenic bladder
Urine culture
Urinalysis and serum BUN
Post-void catheterization
Cystometrography
What medications may be used to treat neurogenic bladder
Betanechol, Anticholinesterase drugs, neostigmine, anticholinergic drugs
What dietary considerations could be beneficial for neurogenic bladder
Moderate to high fluid intake, and a diet that acidifies the urine, Drink cranberry juice
What other treatments are recommended for neurogenic bladder
Bladder retraining. Stroking or pinching the abdomen, inner thigh, or glans penis. Credes Method
What are the risk factors for renal tumors or cancer
Chronic irritation, obesity, smoking. The chemicals and dyes used in the plastics and rubber cable industries; substances in the work environment of textile workers, leather finishers, spray painters, hairdressers, analgesic agents >60 male residence in urban areas
What are the signs and symptoms of renal tumors or cancer?
Hematuria
Systemic manifestations, fever without infection, fatigue, weight loss, hormones or hormone-like substances.
What diagnostic tests are used when renal tumors are suspected
Renal ultrasonography, CT scan, IVP and MRI, Renal angiography, Aortography, and inferior venacavography. Chest X-Ray, bone scan and liver function studies
How are renal tumors or cancer treated?
Radical Nephrectomy, regional lymph nodes may also be resected, biologic therapies such as interferon
Identify six nursing diagnoses applicable to a post-op nephrectomy patient?
Pain, ineffective breathing pattern, risk for impaired urinary elimination, anticipatory grieving
How would you teach a patient following a nephrectomy to protect the remaining kidney
Preventing UTI, renal calculi, and trauma. Maintain a fluid intake of 2000-2500 ml per day. Increase exercise tolerance
List the aminoglycosides that are nephrotoxic
Amikacin
Gentamicin
Kenamycin
Netilmicin
Streptomycin
Tobramycin
What other meds are nephrotoxic
NSAIDS, some chemotherapy drugs, heavy metals, radiology, contrast medium, rocephin, lasix, lithium
Describe ESWL Extracorporeal shock wave lithotripsy
It is a noninvasidve technique for fragmenting kidney stones using shock waves generated outside the body. Acousic shock waves are aimed under fluoroscopic guidance at the stone. These shock waves travel through soft tissue without causing damage, but shatter the stone as its greater density stops their progress. Repeated shock waves pulverize the stone into fragments small enough to be eliminated in the urine. The procedure may require 30 minutes to 2 hours.
Define hydronephrosis and what is the impact of this problem on long term kidney function
It is distention of the renal pelvis and calyces, and hydroureter, distention of the ureter, are possible results. If the pressure is unrelieved, the collecting tubules, proximal tubules, and glomeruli of the kidney are damaged, causing a gradual loss of renal function.
Describe a cystoscopy and what does it help diagnose?
Direct visualization of the urethra and bladder through a cystoscope, may be used to diagnose conditions such as prostatic hypertrophy, urethral strictures, bladder calculi, tumors, polyps, or diverticula, and congenital abnormalities. A tissue biopsy may be obtained during the procedure and other interventions performed.
Foods which are high in purines are included in which group?
A. Cheese, eggs, grapes.
B. Organ meats, sardines, pork.
C. Green vegetables, fruits.
D. Nuts, teas, colas.
B. Organ meats, sardines, pork.
2. A diet that is low in purines is indicated to help prevent which type of kidney stone?
A. Calcium.
B. Cystine..
C. Calcium oxalate..
D. Uric Acid.
D. Uric Acid.
3. Which is the highest priority Nursing Diagnosis following a radical nephrectomy?
A. Anticipatory Grieving.
B. Knowledge Deficit..
C. Impaired Skin Integrity..
D. Pain.
D. Pain.
A nurse is evaluating discharge instructions to a client admitted for urolithiasis. Which of the following statements made by the client indicates to the nurse a need for further instructions?
A. "I will report any changes in the amount or character of urine to my physician."
B. "If I have any pain during urination, I will inform my physician."
C. "I will drink at least 2000 mL of fluid per day."
D. "I will report any blood in my urine."
C. "I will drink at least 2000 mL of fluid per day."
Measures to prevent further urolithiasis include increasing fluid intake to 2500 to 3500 mL per day. The client is also instructed to report any changes in the amount or character of urine. Dysuria, frequency, urgency, and cloudy urine are symptoms of a urinary tract infection, often associated with urolithiasis. Hematuria is often associated with calculi and with procedures used to remove stones.
Evaluation; Physiological Integrity; Analysis
A client with urinary incontinence is identifying measures to maintain continence. Which of the following measures described by the client indicates to the nurse a need for further instructions?
A. "I maintain a voiding diary and record every voiding and fluid intake."
B. "I don't use any artificial sweeteners."
C. "I avoid all caffeine."
D. "I consume no more than 1000 mL of fluid per day."
D. "I consume no more than 1000 mL of fluid per day."
A female client is prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) for the treatment of an acute urinary tract infection. The client's medical history includes Type II diabetes and hypertension. Which of the following does the nurse include in teaching the client about this medication? [Hint]
A. The medication should be taken with meals and with a full glass of water.
B. Diabetic clients receiving oral hypoglycemic agents and sulfonamides are at increased risk of hypoglycemia and should monitor closely for hypoglycemic manifestations.
C. Clients with hypertension taking sulfonamides are at an increased risk of hypotension and should be monitored closely for hypotensive manifestations.
D. The physician should be notified immediately if a discoloration of urine is noted.
B. Diabetic clients receiving oral hypoglycemic agents and sulfonamides are at increased risk of hypoglycemia and should monitor closely for hypoglycemic manifestations.

The client is instructed that diabetics receiving oral hypoglycemic agents and sulfonamides are at increased risk of hypoglycemia and should monitor closely for hypoglycemic manifestations. The medication is taken on an empty stomach 1 hour before or 2 hours after meals, with a full glass of water. Sulfonamides may cause urine to turn orange. The discoloration is harmless. Sulfonamides do not affect blood pressure in hypertensive clients.
Planning; Physiological Integrity; Application
The nurse, assessing a client post cystoscopy, expects which of the following assessment findings?
A. Decreased urine output in the first 24 hours post procedure
B. Flank pain in the first 24 hours post procedure
C. Bloody urine and burning on urination the first post procedure void
D. Bright red bleeding in the first 24 hours post procedure
C. Bloody urine and burning on urination the first post procedure void
A client is 3 hours postoperative bladder tumor surgery and creation of ileal conduit. Which of the following assessment findings by the nurse requires immediate intervention?
A. Stoma slightly edematous
B. Bright red stoma
C. Bright red urine
D. Urine output 20 mL the past hour
D. Urine output 20 mL the past hour
A nurse planning to irrigate a client's ileal diversion catheter anticipates using which of the following solutions?
A. Normal saline
B. Tap water
C. Fleets enema
D. Sterile water
A. Normal saline

Normal saline is used for the irrigation of the ileal diversion. Irrigation may be necessary because mucus produced by the bowel wall may accumulate in the newly devised reservoir or obstruct catheters. The irrigation is generally performed every 4 hours or as ordered by the physician.
Planning; Physiological Integrity; Analysis
A nurse is providing client instructions for a 24-hour urine collection to be obtained at home. Which of the following statements made by the client indicates a need for further instructions?
A. "I will take the full specimen and requisition to the lab once the 24 hour period has ended."
B. "I will begin my urine collection with the first void in the morning."
C. "When the time period is to end, I will empty my bladder and save as part of the total specimen."
D. "I will collect urine in the urine-collection device provided to me."
B. "I will begin my urine collection with the first void in the morning."

When collection is to begin, clients are instructed to completely empty the bladder and discard that urine. The other responses by the client are appropriate interventions for the 24-hour urine collection.
Evaluation; Physiological Integrity; Analysis
A nurse is observing a client performing self care of a urinary stoma. Which of the following actions by the client demonstrates a need for further teaching?
A. Places a rolled gauze square over the stoma opening during cleansing
B. Applies the collection bag with an opening of 3 mm wider than the outside of the stoma
C. Cleanses around the stoma with soap and water, then rinses and pats dry
D. Allows skin barrier to dry before applying collection bag
B. Applies the collection bag with an opening of 3 mm wider than the outside of the stoma
A client is receiving bethanechol chloride (Urocholine) subcutaneously for treatment of acute postoperative urinary retention. In planning care for this client, the nurse anticipates the administration of which of the following as an antidote for bethanechol overdose or toxicity?
A. Regitine
B. Narcan
C. Atropine
D. Epinephrine
C. Atropine

Atropine is the specific antidote for bethanechol overdose or toxicity. It should be kept readily available when this drug is administered subcutaneously.
Planning; Physiological Integrity; Application
What meds treat a urinary tract tumor
Immunologic or chemotherapeutic agents administered by intravesical instillation (into the bladder) may be used either as the primary treatment for bladder cancer or to prevent recurrence following endoscopic tumor removal. Bacilli Calmette-Guerin is a suspension of attenuated Mycobacterium bovis used to treat CIS and recurrent bladder tumors. Instillation into the bladder causes a local inflammatory reaction that eliminates or reduces superficial tumors.
What are adverse reactions to intravesical chemotherapy, which treats Bladder tumors?
Bladder irritation, frequency, dysuria, and contact dermatitis.
Describe Transurethral tumor resection
Transurethral tumor resection may be performed by excision, fulguration (destruction of tissue using electric sparks generated by high-frequency current) or laser photocoagulation (use of light energy to destroy abnormal tissue). Laser surgery carries the lowest risk of bleeding and perforation of the bladder wall. Following cytoscopic tumor resection, clients are followed at 3 month intervals for tumor recurrence.
Describe a Cystectomy
Surgical removal of the bladder is necessary to treat invasive cancers. Partial cystectomy may be done to remove a solitary lesion; however, radical cystectomy is the Standard treatment for invasive tumors. The bladder and adjacent muscles and tissues are removed.
What are the most important mechanisms for maintaining sterility of the urinary tract (above the urethra)
1. Adequate urine volume
2. A free flow from the kidneys through the urinary meatus
3. Complete bladder emptying

Other defenses: Normal acidity, bacteriostatic properties of the bladder and urethral cells.
List and define the types of urinary tract infections
Lower urinary tract infections:
Urethritis-inflammation of the urethra
Prostatitis-inflammation of the prostate gland
Cystitis-inflammation of the urinary bladder

Upper urinary tract infections
Pyelonephritis-inflammation of the kidney and renal pelvis.
List the risk factors for UTI
Female:
Short, straight urethra
Proximity of urinary meatus to vagina and anus
Sexual intercourse
Use of diaphragm and spemicidal compounds for birth control
Pregnancy

Male
Uncircumcised
Prostatic hypertrophy
Rectal intercourse

Both
Aging
Urinary tract obstruction
Neurogenic bladder dysfunction
Vesicoureteral reflux
Genetic factors
Catheterization
What is the most common UTI. Describe this UTI
Cystitis. The infection tends to remain superficial, involving the bladder mucosa. The mucosa becomes hyperemic (red) and may hemorrhage. The inflammatory response causes pus to form. This process causes the classic manifestations associated with cystitis.
Symptoms of Cystitis-
Presenting symptoms
Dysuria-painful/difficult urination
Urgency/frequency
Nocturia-voiding 2 or more times at night
Hematuria-bloody urine
Foul odor to urine
May appear cloudy (pyuria)
Suprapubic pain and tenderness.
Occurs more frequently in adult females.
Define Pyelonephritis
Name and define the two types of pyelonephritis
Pyelonephritis is an inflammation of the renal pelvis and parenchyma, the functional kidney tissue.
Acute Pyelonephritis is a bacterial infection of the kidney;
Chronic pyelonephritis is associated with nonbacterial infections and inflammatory processes that may be metabolic, chemical, or immunologic in origin. It involves chronic inflammation and scarring of the tubules and interstitial tissues of the kidney. It is a common cause of chronic renal failure.
Manifestations of Acute pyelonephritis
Urinary
Urinary frequency
Dysuria
Pyuria
Hematuria
Flank pain
Costovertebral tenderness

Systemic
Vomiting
Diarrhea
Acute fever
Shaking chills
Malaise
Describe Intravenous pyelography IVP
Also known as excretory urography, is used to evaluate the structure and excretory function of the kidneys, ureters, and bladder. As the kidneys clear, an intravenously injected contrast medium from the blood, the size and shape of the kidneys, their calices and pelvises, the ureters, and the bladder can be evaluated, and structural or functional abnormalities, such as vesicoureteral reflux, may be detected
Describe Voiding Cystourethrography
Involves instilling contrast medium into the bladder, then using X-rays to assess the bladder and urethra when filled and during voiding. This study can detect structural or functional abnormalities of the bladder and urethral strictures. This test has a lower risk of allergic response to the contrast dye than IVP
Describe Cystoscopy
Direct visualization of the urethra and bladder through a cystoscope, may be used to diagnose conditions such as prostatic hypertrophy, urethral strictures, bladder calculi, tumors, polyps, or diverticula, and congenital abnormalities. A tissue biopsy may be obtained during the procedure, and other interventions performed.
Nursing implications for IVP
Preparation: ask about allergy to seafood, iodine, or radiologic contrast dye
Assess renal and fluid status: serum osmolality, creatinine and blood urea nitrogen levels
Instruct client to complete ordered pretest bowel preparation including prescribed laxative or cathartic the evening before the test, and an enema or suppository the morning of the test. Withold food for 8 hours prior to test, clear liquids allowed
After test
Monitor vital signs, signs of allergic reaction, urine output
Cystoscopy client and family teaching
Cystoscopy is performed in a special systoscopy room, using a local or general anesthesia. You may feel some pressure or a need to urinate as the scope is inserted through the urethra into the bladder. Takes 30-45 min.
Do not attempt to stand without assistance
Burning on urination for a day or two after the procedure is to be expected
Warm sitz baths, analgesic agents, and antispasmodic medications may relieve discomfort after the procedure.
Major causes of Urinary Tract Obstruction by Location
Kidney Pelvis:
Calculi, Polycystic kidney disease, Infection and scarring
Ureters:
Calculi, scarring and stricture, congenital defects or strictures, external processes such as pregnancy, tumors, lymph node enlargement
Bladder:
Neurogenic bladder
Tumors
Calculi and other foreign bodies
Urethra
Benign prostatic hypertrophy
Tumors
Scarring and stricture
Trauma
Urinary anti-infectives
Name 2
nursing implications/what are they used for
Nitrofurantoin (Furadantin; Macrodantin)
Trimethoprim (proloprim, trimpex)
Urinary anti-infectives are usually used prophylactically to prevent recurrence of UTI in clients with frequent symptomatic infections. Nitrofurantoin also may be used to treat UTI in pregnant women
Nursing responsibilities for those on Urinary Anti-infectives
Fluid intake!!!!
Administer with meals
Trimethoprim is contraindicated for use in clients with renal or hepatic impairment; nitrofurantoin is contraindicated for clients with impaired renal function. Report abnormal lab values
Use with caution in elderly or chronically ill pts
Monitor for signs of phenytoin toxicity (sedation, ataxia, and increased blood levels) if trimethorim is given concurrently.
Nitrofurantoin turns the urine brown. Not harmful.
If taking trimethoprim along with phenytoin (dilantin) or a related anticonvulsant, contact Dr. if you become sedated or begin to stagger.
Urinary Analgesic: Name 1 and describe, give nursing responsibilities and pt teaching points
Phenazopyridine (Pyridium)
Phenazopyridine is a urinary tract analgesic that may be used for symptomatic relief of the pain, burning, frequency, and urgency associated with UTI during the first 24-48 hours of therapy. Its use is somewhat controversial, because it does not treat infection and may delay effective treatment in the client with recurrent UTI who saves a dose or two “for the next time.”
Nursing Responsibilities
Monitor renal function (output, weight, serum creatinine and BUN)
Stop drug if sclera or skin become yellow-tinged. May indicate reduced excretion and toxicity
Client/Family teaching
Take with meals
Turns urine orange or red.
Contact Dr. if symptoms of UTI occur
If you notice yellow tone to skin or eyes stop drug, contact Dr.
Define/describe Ureteroplasty
Surgical repair of a ureter, may be indicated for a structural abnormality or stricture of a ureter. This may be combined with a ureteral reimplantation if vesicoureteral reflux is present. The client returns from these surgeries with an indwelling urinary catheter (Foley or suprapubic) and a ureteral stent ( a thin catheter inserted into the ureter to provide for urine flow and ureteral support), which remains in place for 3-5 days.
What is a ureteral stent for?
Ureteral stents are used to maintain patency and promote healing of the ureters.
Nursing Diagnosis: Impaired Urinary Elimination, describe, and give interventions
Inflammation of the bladder and urethral mucosa affects the normal process and patterns of voiding, causing frequency, urgency, and burning on urination, as well as nocturia. Urine may be blood tinged, cloudy, etc.
Instruct to avoid caffeinated drinks, including coffee, tea, and cola; citrus juices, drinks containing artificial sweeteners, and alcoholic beverages.
Provide perineal care on a regular basis
Use aseptic urinary catheterization.
List three factors that contribute to urolithiasis
Supersaturation
Nucleation
Lack of inhibitory substances in the urine
Manifestations of urinary calculi
Kidney stones
Often asymptomatic
Dull, aching flank pain
Microscopic hematuria
Manifestations of UTI
Ureteral Stones
Renal colic
Acute, severe flank pain on affected side
Often radiates to suprapubic region, groin, and external genitals
Nausea, vomiting, pallor, and cool, clammy skin
Bladder stones
May be asymptomatic
Dull suprapubic pain, possibly associated with exercise or voiding
Gross or microscopic hematuria
Manifestations of UTI
When does renal colic develop
Renal colic, acute severe flank pain on the affected side, develops when a stone obstructs the ureter, causing ureteral spasm. The pain of renal colic may radiate to the suprapubic region, groin, and external genitals. The severity of pain often causes a sympathetic response with associated nausea, vomiting, pallor, cool, clammy skin.
Nursing implications for 24 hour urine specimen
When collection is to begin, instruct client to completely empty the bladder and discard this urine.
Save all urine produced during the 24 hour period in a container, refrigerating it or keeping it on ice as indicated.
When the collection period is to end, have the client empty the bladder completely and save this specimen as part of the total. Take the full specimen with requisition to the lab for analysis.
Client teaching
Urinate before you move your bowels; do not discard any toilet tissue in the urine container.
Manifestations of
Acute and Chronic Hydronephrosis
Acute
Acute, colicky pain
May radiate into the groin
Hematuria, pyuria
Fever
Nausea, vomiting, abdominal pain
Chronic
Dull, aching flank pain
Hematuria, pyuria
Fever
Palpable flank mass.
Define/Describe Hydronephrosis
Distention of the renal pelvis and calyces, and hydroureter, distention of the ureter, are possible results. If the pressure is unrelieved, the collecting tubules, proximal tubules, and glomeruli of the kidney are damaged, causing a gradual loss of renal function.
What inhibits lithiasis
A thiazide diuretic, frequently prescribed for calcium calculi, acts to reduce urinary calcium excretion and is very effective in preventing further stones. Potassium citrate alkalinizes urine (raises pH), and is often prescribed to prevent stones that tend to form in acidic urine (uric acid, cystine, and some forms of calcium stones).
Define/Describe Lithitropsy
Lithotripsy, using sound or shock waves to crush a stone, is preferred treatment for urinary calculi. Several techniques are available.
Extracorporeal shock wave lithotripsy (ESWL) is a noninvasive technique for fragmenting kidney stones using shock waves generated outside the body.
Percutaneous ultrasonic lithotripsy uses a nephroscope inserted into the kidney pelvis through a small flank incision. The stone is fragmented using a small ultrasonic transducer, and the fragments are removed through the nephrscope. Laser lithotripsy is an alternative to ultrasonic lithotripsy. Laser beams are used to disintegrate the stone, without damaging soft tissue. A nephroscope or a ureteroscope (passed up the ureter from the bladder during cystoscopy) is used to guide the laser probe into direct contact with the stone.
Pyelolithotomy is incision into and removal of a stone from the kidney pelvis. A staghorn calculus which invades the calices and renal parenchyma may require a nephrolithotomy for removal.