'Kidney Stone Ncp\r'

'Kidney muffin C be Plan Admitting Diagnoses: Client not being admitted at this time received Diagnosis: Ureteral Calculi Other Medical Diagnoses: HTN, Hyperlipidemia, Kidney stones, Smokes Tobacco, Tonsillectomy-child stick yrs. Pathophysiology: urinary calculi ar solid particles in the urinary system. They whitethorn cause torture, nausea, vomiting, hematuria, and, possibly, chills and feverishness due to secondary infection. Diagnosis is ground on urinalysis and radiologic imaging, usually noncontrast verticillate CT. Treatment is with analgesics, antibiotics for infection, and, sometimes, shock wave lithotripsy or endoscopic procedures.About 1/1000 adults in the US is hospitalized annually because of urinary calculi, which are also found in near 1% of all autopsies. Up to 12% of men and 5% of women will develop a urinary calculus by age 70. Calculi vary from microscopic coherent foci to calculi several centimeters in diameter. A spectacular calculus, called a staghorn calculus, can fill an constitutional nephritic calyceal system. About 85% of calculi in the US are sedate of Ca, mainly Ca oxalate. Composition of urinary calculi; 10% are uric acidic; 2% are cystine; most of the relaxation are Mg ammonium inorganic phosphate (struvite).General risk factors take on disorders that increase urinary salt concentration, either by increase excretion of Ca or uric acid salts, or by diminish excretion of urine or citrate. Urinary calculi may remain within the renal parenchyma or renal pelvis or be passed into the ureter and bladder. During passage, calculi may irritate the ureter and may become lodged, obstructing urine flow and do hydroureter and sometimes hydronephrosis. (Preminger, MD, 2012) Common areas of lodgment include the ureteropelvic junction, the distal ureter, and the ureterovesical junction.Larger calculi are more believably to become lodged. Typically, a calculus must(prenominal) nominate a diameter > 5 mm to become lodged. Calculi ? 5 mm are likely to pass spontaneously. still partial obstruction causes decreased glomerular filtration, which may persist briefly later the calculus has passed. With hydronephrosis and elevated glomerular pressure, renal blood flow declines, further decline renal function. Generally, however, in the absence of infection, persistent renal dysfunction occurs only later about 28 days of realized obstruction.Secondary infection can occur with long-standing obstruction, scarce most diligents with Ca-containing calculi do not have infected urine. Preminger, MD, G. M. (n. d. ). Nephrolithiasis; stones; urolithiasis. Retrieved from http://www. merckmanuals. com/professional/genitourinary_disorders/urinary_calculi/urinary_calculi. hypertext mark-up language Textbook clinical symptoms: The major look of stones is severe nuisance, commonly called renal colic. fender pain suggests the stone is located in the kidney or upper ureter. Flank pain that extends toward the abdome n or to the scrotum and testes or the vulva suggests that stones are in the ureters or bladder.Nausea, vomiting, pallor, and diaphoresis oft accompany the pain. Frequency or dysuria occurs when a stone reaches the bladder. (Ignatavicius & Workman, 2010) pg 1571 Actual symptoms: Flank pain extending toward the abdomen, dizziness, sweating, and nausea w/o vomiting. forbearing states his pain is an 8/10 on the pain scale. Pain is described as constant and sharp with no alleviating factors. Complications or potential complications: Potential; Hydroureter, hematuria, hydronephrosis, abrasion, oliguria or anuria, and infection. Ignatavicius & Workman, 2010) pg 1571-1572 precaution Issues: Fall risk level †Low, but still a potential complication from patient’s c/o dizziness from pain. Delegation Issues: Assist patient when ambulating. |Client Data | |Age | |38 | |Physical Exam (include all form systems) | (Physical Exam) | |Age | |38 | | | |Male | | | | me ridian | |69. in | |Weight | |180lb | |Temp | |99F | | pulse | |90 | |Apical Pulse | |88 | |Resp | |20 | |BP | |169/71 | |BP supine | |( observe | |O2 Saturation | |100% RA | | | | | |NEURO: nonfocal, AXOX4, c/o pain. |HEENT: Denies headache; PERRLA, Ears unobstructed, symmetrical, no discharge of hearing, Nares are clear, w/o drain or obstruction, Oropharynx is clear w/ | |membranes tip in color and intact, Neck is mobile with full range of motion, | |INTEGUMENT: Skin warm, moist-diaphoretic, intact w/saline lock in RU-AC, dressing is clean, intact, non-tender, free of redness. | |CARDIOVASCULAR: No JVD noted, apical pulse regular at 88bpm, S1/S2 auscultated, no c/o thorax pain/pressure | |distal pulses palpated in all extremities, capillary refill\r\n'