Page 1860 - Saunders Comprehensive Review For NCLEX-RN

urinary tract; however, the most frequent site is the
kidneys.
2. Problems resulting from calculi are severe intermittent
pain, obstruction, tissue trauma, secondary
hemorrhage, and infection.
3. The stone can be located through radiography of the
kidneys, ureters, and bladder; IV pyelography;
computed tomography (CT) scanning; and renal
ultrasonography.
4. A stone analysis is done after passage to determine the
type of stone and assist in determining treatment.
5. Urolithiasis refers to the formation of urinary calculi;
these form in the ureters.
6. Nephrolithiasis refers to the formation of kidney
calculi; these form in the renal parenchyma.
7. When a calculus occludes the ureter and blocks the
flow of urine, the ureter dilates, producing
hydroureter (see Fig. 54-5).
8. If the obstruction is not removed, urinary stasis results
in infection, impairment of renal function on the side
of the blockage, hydronephrosis (see Fig. 54-5), and
irreversible kidney damage.
B. Causes
1. Family history of stone formation
2. Diet high in calcium, vitamin D, protein, oxalate,
purines, or alkali
3. Obstruction and urinary stasis
4. Dehydration
5. Use of diuretics, which can cause volume depletion
6. UTIs and prolonged urinary catheterization
7. Immobilization

8. Hypercalcemia and hyperparathyroidism
9. Elevated uric acid level, such as in gout
C. Assessment

1. Renal colic, which originates in the lumbar

region and radiates around the side and down to the
testicles in men and to the bladder in women

2. Ureteral colic, which radiates toward the

genitalia and thighs
3. Sharp, severe pain of sudden onset
4. Dull, aching pain in the kidney
5. Nausea and vomiting, pallor, and diaphoresis during
acute pain
6. Urinary frequency, with alternating retention

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