NR-570 Common Diagnosis and Management in Acute Care Practicum
Final Exam (Latest Update)
Question:
Where is the stone located if the patient has pain in the groin region?
Answer:
pain that radiates downward into the groin indicates the stone has passed into the lower third of the ureter
Question:
Vague flank pain or acute colicky pain with increasing intensity means the stone is located where?
Answer:
stones in renal pelvis
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Question:
Differential Diagnosis for abdominal pain and/or flank pain:
Answer:
Nephrolithiasis (kidney stones) Pyelonephritis (kidney infection) Ectopic pregnancy Ovarian or testicular torsion Appendicitis Bowel obstruction Diverticulitis Rupture of aortic aneurysm
Question:
Right lower abdominal tenderness with a +Blumberg sign. What should be suspected?
Answer:
Blumberg sign: Rebound tenderness in the RLQ, caused by acute peritonitis.
*Appendicitis
Question:
What labs do we run to diagnose a kidney stone?
Answer:
UA dipstick, urine microscopy and urine C&S 2 / 4
Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
Question:
What radiology methods are preferred for outpatient treatment and why
Answer:
inexpensive, easily accessible. in combo its more practical -KUB xray -Renal Ultrasound
Question:
What stones can be seen on a KUB?What stone can you not see on a KUB
Answer:
CAN see: Calcium oxalate - most common type of stone
CANNOT see: uric acid stones (radio translucent)
Question:
What is a Renal Ultrasound used for when testing for kidney stones?
Answer:
good for assessing for hydronephrosis (excess fluid in the kidney d/t back up of urine that can be caused by an obstruction). Bad for identifying a stone. 3 / 4
Question:
What is the GOLD STANDARD for diagnosing a kidney stone?
Answer:
Non-contrast CT scan.
Question:
Goal of renal calculi treatment
Answer:
focused on symptomatic relief pain medications -NSAID or narcs antiemetics -n/v facilitate stone passage-Thiazide diuretics, alpha-blockers or calcium channel blockers to help facilitate the passage of a stone. Terazosin -alpha blockers used for BPH.
Question:
<5 mm renal calculi can
Answer:
be passed through the urine. may only require NSAIDs for management.
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