Medical-surgical Nursing Demystified

(Sean Pound) #1

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.

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