CHAPTER 9 Genitourinary System^383
PROGNOSIS
A stone may lodge in the ureter blocking the flow of urine. Hydronephrosis and
swelling of the ureter may follow. Kidney stones typically recur, especially in those
with a family history of nephrolithiasis.
HALLMARK SIGNS AND SYMPTOMS
- Hematuria
- Unilateral spasms of pain in the flank area (renal colic)
- Pain may radiate to lower abdomen, groin, scrotum or labia
- Nausea, vomiting, and sweating associated with occurrence of pain
- Elevated blood pressure with pain
- Extreme flank pain that comes slowly or quickly
INTERPRETING TEST RESULTS
- Urinalysis shows red blood cells.
- Ultrasound shows stones.
- X-ray of kidneys, ureters, and bladder (KUB) shows stones.
- CT scan shows stones.
- MRI shows stones.
TREATMENT
- Provide pain relief:
- narcotics such as morphine
- non-narcotics such as ketorolac, a nonsteroidal anti-inflammatory
- Administer antispasmodics as adjuncts for pain control.
- Increase fluid intake to flush through the urinary tract.
- Lithotripsy—shock waves are used to break the stone into very small pieces
that can pass more easily. - Stent placement to allow free flow of urine and passage of small stones or
stone pieces. - Surgical removal of stone.