This essay will focus on a patient that presented to the emergency department with an acute onset of severe pain in the flank region, and then later was admitted for a procedure called “Shockwave lithotripsy (SWL)” ("Surgery for Kidney Stones," para. 4). The aim of this essay is to demonstrate how this client’s diagnosis was determined. I will also include the pathophysiology, client presentation, medical history, clinical examinations and findings, diagnostic tests that were performed, other possible diagnoses and finally my conclusion. Verbal consent was given by the client and he was assured that all the information I obtained from him would be kept confidential and his identity would not be compromised in anyway.
The client chosen for this essay was a twenty year old European male. I will refer to him as Mr A. Mr. A presented to the emergency department waiting room to seek treatment for the onset of severe flank pain. After all the appropriate tests where completed Mr. A was diagnosed with renal calculi or kidney stones which are characterised as “crystallized mineral chunks that can potentially develop in the renal pelvis or calyces” (Patton & Thibodeau, 2010, p. 970). Kidney stones are most likely to occur in men between ages 20 - 30. They can also combine with other minerals to form the kidney stone ("Kidney stones: MedlinePlus Medical Encyclopedia,"). If the stones are small enough, they can easily be voided when the patient urinates. Many calculi develop as calcium and other minerals crystallize on the renal papillae, and then break off into the urine. If the stones are larger they may obstruct the ureters, this can then cause severe pain which is called renal colic this pain is the same that Mr A presented with. “Renal colic pain is caused as rhythmic muscle contractions of the ureter attempt to expel the stone” (Patton & Thibodeau, 2010, p. 970). Hydronephrosis can then occur. Harris, Nagy, & Vardaxis (2010), inform us that Hydronephrosis is distension of the pelvis and calyces of the kidney by urine that can’t flow past an obstruction such as kidney stones. In some cases surgical repair or removal of the obstruction may be necessary as prolonged Hydronephrosis causes atrophy and eventual loss of kidney function (p. 841). Mr A presented with a severe onset of flank pain, nausea and vomiting. Mr A states this started about 3 days ago, Mr A cannot place an activity that may have caused this pain. He described these pains as sharp and stabbing. He has missed work for the last three days because of these symptoms. He relieves these by sleeping and lying in the fetal position. He states there is little relief when Paracetamol is used. Mr A is worried that this may be related to kidney stones as it runs in his family; his grandfather was diagnosed with it. He is concerned that if this is not diagnosed it will interfere with his work. He eats three meals a day and drinks a “few cups of liquid a day”. Curhan, Willett, Rimm, & Stampfer (1993), inform us that fluid intake is very important in reducing the risk of kidney stones occurring it is recommended that at least 2 litres of water per day are to be consumed. In two large observational studies, fluid intake was found to be …show more content…
(2008). Potter & Perry's fundamentals of nursing (3rd ed.). Chatswood, N.S.W: Elsevier Australia.
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1993). A Prospective Study of Dietary Calcium and Other Nutrients and the Risk of Symptomatic Kidney Stones. New England Journal of Medicine, 328, 833-838. doi:10.1056/NEJM199303253281203
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1999). Family History and Risk of Kidney Stones. Journal of Urology, 8(10), 1568-1573. doi:10.1016/S0022-5347(05)68665-X
Harris, P., Nagy, S., & Vardaxis, N. J. (2010). Mosby's dictionary of medicine, nursing and health professions (2nd ed.). Chatswood, N.S.W: Elsevier Australia.
Kidney Stones in Adults. (n.d.). Retrieved from http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx#diagnosed
Kidney stones: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000458.htm
Macfarlane, M. T. (2006). Urology (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
Miller, N. L., & Lingeman, J. E. (2007). Management of kidney stones. British Medical Journal, 334(7591), 468-478.
The client chosen for this essay was a twenty year old European male. I will refer to him as Mr A. Mr. A presented to the emergency department waiting room to seek treatment for the onset of severe flank pain. After all the appropriate tests where completed Mr. A was diagnosed with renal calculi or kidney stones which are characterised as “crystallized mineral chunks that can potentially develop in the renal pelvis or calyces” (Patton & Thibodeau, 2010, p. 970). Kidney stones are most likely to occur in men between ages 20 - 30. They can also combine with other minerals to form the kidney stone ("Kidney stones: MedlinePlus Medical Encyclopedia,"). If the stones are small enough, they can easily be voided when the patient urinates. Many calculi develop as calcium and other minerals crystallize on the renal papillae, and then break off into the urine. If the stones are larger they may obstruct the ureters, this can then cause severe pain which is called renal colic this pain is the same that Mr A presented with. “Renal colic pain is caused as rhythmic muscle contractions of the ureter attempt to expel the stone” (Patton & Thibodeau, 2010, p. 970). Hydronephrosis can then occur. Harris, Nagy, & Vardaxis (2010), inform us that Hydronephrosis is distension of the pelvis and calyces of the kidney by urine that can’t flow past an obstruction such as kidney stones. In some cases surgical repair or removal of the obstruction may be necessary as prolonged Hydronephrosis causes atrophy and eventual loss of kidney function (p. 841). Mr A presented with a severe onset of flank pain, nausea and vomiting. Mr A states this started about 3 days ago, Mr A cannot place an activity that may have caused this pain. He described these pains as sharp and stabbing. He has missed work for the last three days because of these symptoms. He relieves these by sleeping and lying in the fetal position. He states there is little relief when Paracetamol is used. Mr A is worried that this may be related to kidney stones as it runs in his family; his grandfather was diagnosed with it. He is concerned that if this is not diagnosed it will interfere with his work. He eats three meals a day and drinks a “few cups of liquid a day”. Curhan, Willett, Rimm, & Stampfer (1993), inform us that fluid intake is very important in reducing the risk of kidney stones occurring it is recommended that at least 2 litres of water per day are to be consumed. In two large observational studies, fluid intake was found to be …show more content…
(2008). Potter & Perry's fundamentals of nursing (3rd ed.). Chatswood, N.S.W: Elsevier Australia.
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1993). A Prospective Study of Dietary Calcium and Other Nutrients and the Risk of Symptomatic Kidney Stones. New England Journal of Medicine, 328, 833-838. doi:10.1056/NEJM199303253281203
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1999). Family History and Risk of Kidney Stones. Journal of Urology, 8(10), 1568-1573. doi:10.1016/S0022-5347(05)68665-X
Harris, P., Nagy, S., & Vardaxis, N. J. (2010). Mosby's dictionary of medicine, nursing and health professions (2nd ed.). Chatswood, N.S.W: Elsevier Australia.
Kidney Stones in Adults. (n.d.). Retrieved from http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx#diagnosed
Kidney stones: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000458.htm
Macfarlane, M. T. (2006). Urology (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
Miller, N. L., & Lingeman, J. E. (2007). Management of kidney stones. British Medical Journal, 334(7591), 468-478.