Kidney stones, also knows as renal calculi, are solid masses made of crystals that can form in the kidneys. The formation of crystals begins in supersaturated urine and can be composed of calcium, oxalate, and uric acid. “Calcium oxalate is by far the most common type of kidney stone. Around 80% of kidney stones are made of calcium and oxalate” (Betz, 2023). Over times, crystals aggregate and grow into larger stones. Contributing factors to stone development include decreased water intake and diet. As the stones grow, they can obstruct the flow of urine within the urinary tract. “Kidney stones can be a painful medical issues” and can cause potential damage to the kidney tissue. Small stones may pass through the urinary tract without significant symptoms. However, large stones can cause severe pain as they try to pass through the ureter.
Males may develop kidney stones more than women. Clinical manifestations of a healthy 45-year-old male may include flank pain, nausea, vomiting, hematuria, as well as frequent and/or painful urination. “In men, pain may radiate to the groin area. The pain of renal colic comes and goes but can be intense” (Biggers, 2023). If an obstruction is present, it can lead to urinary tract infections, hydronephrosis and in severe cases, kidney damage. Prognosis of the kidney stones depends on size and location. Some stones will pass on their own and others will need medical intervention.
When someone presents with signs of symptoms related to possible kidney stones, certain labs and diagnostic studies will be performed. A urine sample will be obtained to run a urinalysis to look for signs of infection and blood in urine. The urine may appear dark, cloudy or have blood. Blood tests will be collected to test for calcium, phosphorus, uric acid, electrolytes, kidney function, and for signs of infection. A CT scan will be a diagnostic test ordered to look for a stone.
A patient with symptoms indicating kidney stone or confirmed stone will be given both intravenous fluids and oral fluids to flush kidneys. They will also be given pain medication to help alleviate the pain associated with stone. If stone is determined to be too large to pass, a medical intervention will be decided by urology. A common procedure is extracorporeal shock wave lithotripsy, also knows as ESWL. That breaks the stone into smaller pieces. Additional medications may be given to treat kidney infection or to prevent future stones from forming.
The nurse’s role is to support the patient. This includes managing pain, monitoring signs of complications and by providing education about the condition, treatment options and preventative measures. Kidney stones can be very painful and it is important to support the patient physically, emotionally and psychologically. Each patient may have a different pain tolerance and we should be respectful and show sympathy during their visit. To apply a concept based on the article “Statement of Human Flourishing”, as a nurse you can be compassionate and show love to your patient by tending to their needs. We have been instructed by God to love our neighbors. We can honor that by showing kindness and understanding to our patients when they are suffering.
Betz, M. (2023, April 11). The Kidney Stone Diet: Nutrition to Prevent Calcium Oxalate Kidney Stones. Retrieved from The Kidney Dietitian: https://www.thekidneydietitian.org/kidney-stone-diet/
Biggers, A. (2023, February 6). Everything You Need to Know About Kidney Stones. Retrieved from Healthline: https://www.healthline.com/health/kidney-stones
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