what are the tests made to diagnose kidney stones?… by ashley**xo
does anybody knows.. what are the posible medications given to patients with this kind of disease?
Best Answer:
Kidney stones (renal calculi)are formed of mineral deposits, most commonly calcium oxalate and calcium phosphate; however uric acid, struvite, and cystine are also calculus formers. Renal calculi can remain asymptomatic until passed into a ureter and/or urine flow is obstructed.
A person with kidney stones may report history of recent/ chronic UTI; previous obstruction (calculi); decreased urinary output, bladder fullnes, burning sensation and urgency with urination, diarrhea, hematuria (presence of blood in the urine), pyuria (pus in the urine), and alterations in voiding pattern. Person may also report nausea, vomiting, abdominal tenderness, diet high in purines, calcium oxalate, and/or phosphates, insufficient fluid intake, does not drink fluids well; exhibits abdominal distention, flank pain, elevated BP/pulse, decreased/absent bowel sounds.
diagnostic studies include:
1. urinalysis: color may be yellow, dark brown, bloody. commonly shows RBCs, WBCs, crystals (cystine, uric acid, calcium oxalate), casts, minerals, bacteria, pus; pH may be less than 5 (promotes cystine and uric acid stones) or higher than 7.5 (promotes magnesium, struvite, phosphate, or calcium phosphate stones).
2. biochemical survey: elevated levels of magnesium, calcium, uric acid, phosphate, protein, electrolytes
3. serum and urine BUN/Cr: abnormal (high in serum/low in urine) secondary to high obstructive stone in kidney causing ischemia/necrosis
4. serum chloride and bicarbonate levels: elevation of chloride and decreased levels of bicarbonate suggests developing renal tubular acidosis
5. CBC:
Hgb/Hct:abnormal if client is severely dehydrated or polycythemia is present (encourage precipitation of solids), or client is anemic (hemorrhage, kidney dysfunction or failure)
RBCs: usually normal
WBCs: may be increased (indicating infection or septicemia)
KUB xray: show presence of calculi and/or anatomical changes in the area of the kidney or along the course of the ureter
IVP: provides rapid confirmation of urolithiasis as a cause of abdominal or flank pain. shows abnormalities in anatomical structures (distended ureter) and outline of calculi
cystoureteroscopy: direct visualization of bladder and ureter may reveal stone and/or obstructive effects
CT scan: identify/delineates calculi and other masses; kidney, ureteral, and bladder distention
Kidney Ultrasound: to determine obstructive change, location of stone; without the risk of failure induced by contrast medium
Medications to be given will depend greatly on the type of stones formed.
narcotics e.g., meperidine (demerol), morphine: to promote muscle relaxation
antispasmodics, e.g., flavoxate (Urispas), oxybutynin (Ditropan): to decrease reflex spasm, colic and pain
corticosteroids: to reduce tissue edema to facilitate movement of stone
Acetazolamide (Diamox), allopurinol (Zyloprim); increase urine pH and reduce formation of acid stones. antigout agents such as allopurinol (Zyloprim) also lower uric acid production and potential of stone formation.
Hydrochlorothiazide (Esidrix, HydroDIURIL), chlorthalidone (Hygroton); may be given to prevent urinary stasis and decrease calcium stone formation if not caused by underlying disease process such as primary hyperthyroidism or vitamin D abnormalities.
Ammonium chloride; potassium or sodium phosphate; reduce phosphate stone formation
Antibiotics; presence of UTI/ alkaline urine potentiates stone formation
Sodium bicarbonate; replaces losses incurred during bicarbonate wasting and/or alkalinization of urine; may reduce/prevent formation of some calculi
Ascorbic acid; acidifies urine to prevent recurrence of alkaline stone formation
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