Navigating Acute Kidney Injury: Uncovering the Pathophysiology and Management of Renal Calculi

Assessment 2: Case study essay School of Nursing and Midwifery, Edith Cowan University NUM2306 Adult Health Care 1 Dr Amanda Graf October 11th, 2021 1319 words Table of Contents Introduction3 Pathophysiology3 Management5 Medications6 Conclusion7 References8 Assessment 2: Case study essay Introduction Obstruction to the bladder, ureters and/or kidney can cause Acute Kidney Injury (AKI), and if not treated, can lead to renal failure (Goldfrap, 2016). AKI decreases the functioning abilities of the kidney and the body’s homeostasis, due to the decline in Glomerular Filtration Rate (GFR) (Craft et al., 2019). Kidney stones, also known as renal calculi, are a known cause of postrenal AKI and cause of urinary obstruction (Nevo et al., 2019). In Australia, 10% of the population will experience a kidney stone (Thia & Saluja, 2021). Annually 12,000 hospital admissions are due to renal calculi, noting that 75-90% of incidences pass spontaneously without surgical attention (Cunningham et al., 2016). Key risk factors include poor diet, dehydration, hypercalciuria, PH imbalances, humid climates, and presence of supersaturation in urine (Srivastava et al., 2019). This case study is focussed on patient Sally Jones, a 56-year-old lady, who has a 6mm stone in her right ureter. The pathophysiology of renal calculi and the clinical manifestations that Sally presents will be discussed, along with recommended nursing management and medical interventions that would be put in place for Sally. Pathophysiology Acute Kidney Injury (AKI), previously known as acute kidney failure, is classified by the location of the obstruction/trauma (Goldfrap, 2016). The three classifications are prerenal, intrarenal and postrenal (Craft & Gordon, 2020). Kidney stones are an example of postrenal AKI (Zeimba & Matlaga, 2015), and are characterised by their mineral composition (Shadman & Bastani,2017). Evidence states there are four types of renal calculi, the most being calcium stones, accounting for up to 75% of calculi incidences (Solo et al., 2017). The less common are uric acid stones, struvite stones (Also known as ‘infection stones’, caused by UTIs) and cystine calculi, which are traced to genetic or secondary to a metabolic disorder (Shadman & Bastani, 2017). Moreover, precipitation of these minerals forms small hard crystals due to decrease of urine volume, supersaturation of urine or change in the PH levels (Srivastava