Final Exam: NR570/ NR 570 (Latest 2023/ 2024 Update) Common Diagnosis & Management in Acute Care Practicum Review| Questions and Verified Answers| 100% Correct- Chamberlain

Final Exam: NR570/ NR 570 (Latest 2023/

2024 Update) Common Diagnosis &

Management in Acute Care Practicum

Review| Questions and Verified Answers|

100% Correct- Chamberlain

Q: 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

Q: Vague flank pain or acute colicky pain with increasing intensity means the stone is located

where?

Answer:

stones in renal pelvis

Q: 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

Q: 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

Q: What labs do we run to diagnose a kidney stone?

Answer:

UA dipstick, urine microscopy and urine C&S

Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.

Q: What radiology methods are preferred for outpatient treatment and why

Answer:

inexpensive, easily accessible. in combo its more practical

-KUB xray

-Renal Ultrasound

Q: 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)

Q: 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.

Q: What is the GOLD STANDARD for diagnosing a kidney stone?

Answer:

Non-contrast CT scan.

Q: 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.

Q: <5>

Answer:

be passed through the urine. may only require NSAIDs for management.

Q: >5 mm renal calculi requires what?

Answer:

urology consult.

this may cause an obstruction or kidney failure.

this type of stone may need surgical intervention to be removed.

Q: when is a Urology Referral indicated?

Answer:

stone > 5mm

recurrent stones

Q: When is a hospital admission appropriates for a patient with nephrolithiasis?

Answer:

Hospital admission is indicated when:

-Inability to control pain

-Impaired renal function with an obstructing stone

-Infection (pyelonephritis or sepsis)

-Intractable n/v

Q: What does a 24 hour urine collection analyze?

Answer:

-total volume

-urine pH

-calcium oxalate

-uric acid

-citrate

-sodium

-potassium

-creatinine

Q: Factor Regarding hospital DC for nephrolithiasis

Answer:

-Pain is reasonably controlled

-n/v controlled

Treatment depends on:

Stone type

Location of the stone

Extent of obstruction

Kidney function

Progress of stone passage.