Describe in detail the pathophysiological stages of kidney stones in a working 45-year-old adult male. Explain the clinical manifestations, complications, prognosis, diagnostic tests, and medical treatments and procedures involved. Discuss the nurse’s role in supporting the patient’s psychological, emotional, and spiritual needs. Provide an example integrating concepts from the “Statement of Human Flourishing,” (attached).
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format.
Discussion Post: Pathophysiology and Management of Kidney Stones
Kidney stones, or nephrolithiasis, develop when supersaturated urine facilitates crystallization of solutes such as calcium oxalate, calcium phosphate, or uric acid (Mayo Clinic, 2023). In a working 45-year-old male, this process evolves through stages: nucleation of crystals, growth and aggregation into a stone, and eventual migration into the urinary tract. Dehydration, dietary excess (e.g., high oxalate or sodium), and metabolic abnormalities accelerate this pathophysiology.
Clinically, patients often present with acute, colicky flank pain radiating to the groin, hematuria, nausea, and urgency. Complications include obstruction, hydronephrosis, infection, or renal impairment. Prognosis is generally favorable, though recurrence is common without lifestyle modification.
Diagnostic evaluation includes non-contrast helical CT scans (gold standard), urinalysis revealing microscopic hematuria, serum chemistries (calcium, creatinine, uric acid), and sometimes ultrasound. Treatment depends on stone size and location: small stones (<5 mm) often pass spontaneously with hydration and analgesia, while larger stones may require medical expulsive therapy (e.g., alpha-blockers), extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or percutaneous nephrolithotomy (American Urological Association, 2019).
Nurses play a vital role in holistic care, recognizing that acute pain and recurrent disease can threaten a patient’s emotional and psychological resilience. Supportive interventions include pain management, education on dietary prevention, encouragement, and spiritual support when distress arises.
For example, integrating the “Statement of Human Flourishing,” which emphasizes dignity, purpose, and wellbeing, a nurse might help a patient reframe his experience—encouraging reflection on how overcoming illness can inspire healthier living and personal growth. By fostering a sense of hope and agency, nurses empower patients to flourish beyond illness.
References
American Urological Association. (2019). Medical management of kidney stones: AUA guideline. https://www.auanet.org/guidelines/kidney-stones-medical-management-guideline
Mayo Clinic. (2023). Kidney stones. https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755