When oxalate combines with calcium, which prevents the oxalate from being absorbed in the intestinal tract. It then goes through the kidneys where is can pose a problem. Stones classified by majority of crystal that they are composed of. Foods high is oxalate, rhubarb, star fruit, beets, beet greens, collards, okra, refried beans, spinach, Swiss chard, sweet potatoes, sesame seeds, almonds and soy products, vitamin D, metabolic disorders, and bypass surgery increase calcium oxalate concentration in urine.
pain typically starts at side or back, just below your ribs, and radiates to ones lower abdomen and groin. Often begins when stone reaches ureters
Blood analyis-look at calcium levels Intravenous pyelography: A contrast dye is injected into a vein in your arm and a series of X-rays is taken as the dye moves through your kidneys, ureters and bladder. Helps determine stone location and extent of blockage. Not for pt with renal failure.
IVP = Used to localize the degree and site of obstruction or to confirm the presence of a radiolucent stone)
Need to check the patient’s renal function because this test is contraindicated in patients with renal failure. Contrast has iodine in it. Contraindicated if on metformin.
do not need to over-hydrate since stone has already formed (2000-2200 ml/day) -encourage patient to keep mobile to promote movement of the stone from the upper to lower part of the ureter. Avoid foods high in ____: depends on the type of stone.
Surgery may be needed to remove a kidney stone if it does not pass after a reasonable period of time and causes constant pain is too large to pass on its own or is caught in a difficult place blocks the flow of urine causes an ongoing urinary tract infection damages kidney tissue or causes constant bleeding has grown larger, as seen on follow-up x rays ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into small particles and are easily passed Nephrolithotomy: surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney