Reveals most renal calculi except cystine and uric acid stones Presence of renal stones, most of which are radiopaque Kidney-ureter-bladder and abdominal x-rays Visualizes size, shape, relative position of stone contrast not used with contrast entire urinary collecting system would appear white, masking the stones Helical computed tomography scan without contrast General Comments: The physician uses diagnostic tests to eliminate cholecystitis, peptic ulcers, appendicitis, and pancreatitis as the cause of the abdominal pain. Assess the patient’s ability to handle such changes. Because diet and lifestyle may contribute to the formation of calculi, the patient may face lifestyle changes. Assess the level of the pain as well as the patient’s ability to cope. Patients with renal calculi may be extremely anxious because of the sudden onset of severe pain of unknown origin. Percussion of the abdominal area is normal, but percussion of the costovertebral angle elicits severe pain. Palpate the patient’s flank area for tenderness. Auscultate the patient’s abdomen for normal bowel sounds. Monitor the patient for signs of an infection such as fever, chills, and increased white blood cell counts. Assess the patient for bladder distention. Inspection reveals a patient in intense pain who is unable to maintain a comfortable position. The most typical symptoms of renal calculi are flank pain radiating to the groin, fever, hematuria, nausea, and vomiting. Determine the patient’s history to identify risk factors. In cases in which a urinary tract infection is also present, the patient may report chills and fever. Patients may relate a recent history of hematuria, nausea, vomiting, and anorexia. The pain usually begins in the flank area but later may radiate into the lower abdomen and the groin. The location of the pain varies according to the position of the stone. Establish a history of pain and determine the intensity, duration, and location of the pain. Symptoms of renal calculi usually appear when a stone dislodges and begins to travel down the urinary tract and enters the ureter. Differences in prevalence are thought to be related to diet. People is Asia have a low lifetime risk as compared to Saudi Arabia and North America. Although renal calculi occur in all countries, prevalence is lowest in Greenland and parts of Japan.
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