Kidney stones (also called renal calculi, nursing lecture on kidney stones symptoms, treatment, pathophysiology, and causes for the NCLEX exam.

What are kidney stones, which are also called renal stones or renal calculi? They are hard insoluble crystallized minerals and salts that have formed out of the filtrate produced by the nephron.

Renal stones can vary in size. They can be very hard to see, while others are large like a walnut. In addition, renal calculi are composed of various materials, therefore there are different types of renal stones.

Renal stone types include: calcium oxalate, uric acid, calcium phosphate, struvite, or cystine.

In order for kidney stones to form, there has to be a concentration of minerals and salts in the filtrate. The concentration of minerals can form together to create a crystal (which can grow over time, break off and travel through the urinary system, or cause a blockage). Many predisposing factors can increase the risk of renal calculi formation.

Renal stone causes include: consuming high amounts of oxalate, purine, protein foods or calcium supplements, recurrent urinary tract infections, hyperparathyroidism, hypercalcemia or hypercaluria, high levels of uric acid as with gout, gastrointestinal disorders such as ulcerative colitis, Crohn's Disease, genetic factors, or immobility.

Kidney stone symptoms include: extreme pain (renal colic or ureteral colic), nausea/vomiting, urinary retention, infection.

Treatment for renal stones include extracorporeal shock wave lithrotripsy (ESWL). It is an noninvasive procedure where shockwaves are created to penetrate though the skin and body tissue. Shockwaves will hit the stone and break it down into grains of sand like particles which can be passed out via the urinary system. Another procedure is called a percutaneous nephrolithotomy (invasive and require a surgical incision). This is where the stone is removed by a urologist and doesn't have to be passed as with EWSL. In addition, a ureteroscopy can be performed and this is where a scope is inserted through the urinary system and the stone can be removed or broken.

Nursing interventions for renal calculi include straining the urine, monitoring and encouraging fluid intake, assisting the patient with mobility, monitoring for infection, controlling pain, and educating about the prevention of kidney stones etc.

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