RN Nursing · Renal Calculi · Practice question
A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction?
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Peritoneal dialysis
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Hemodialysis
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Intravenous opioid analgesics
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✓
Placement of a ureteral stent with ureteroscopy
Answer & explanation
Correct: Placement of a ureteral stent with ureteroscopy
Hydronephrosis due to urolithiasis is a urological emergency when there is obstruction causing dilation of the renal collecting system. The definitive treatment to relieve the obstruction is placement of a ureteral stent via ureteroscopy, which bypasses the stone and allows urine to drain from the kidney to the bladder, relieving pressure on the kidney and preventing further renal damage. Alternatively, a percutaneous nephrostomy may be used. Peritoneal dialysis and hemodialysis are renal replacement therapies used when kidneys can no longer filter blood adequately; they do not address the obstructive cause and would not relieve hydronephrosis. Intravenous opioid analgesics are important for pain management in renal colic but do not treat the underlying obstruction or the resulting hydronephrosis; they are supportive, not definitive therapy. The nurse correctly anticipates that ureteroscopy with ureteral stent placement will be performed to decompress the obstructed collecting system, protect renal function, and allow the stone to pass or be removed.
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