genitourinary kidney stone vs aaa lisa chance, rn, bsn, ccrn
TRANSCRIPT
Kidney Stones (calculi) or AAA?
Symptoms of a kidney stone verses abdominal aortic aneurysm (AAA) can be very much alike.www.webster.com You can hear a word pronounced!
Calyces is pronounced “Kay-la-sees.”
One condition is painful annoying
Other can be fatal if not treated promptly.
Vital for nurses to know the difference!
Could be a matter of life & death.
• Hematuria• Severe colicky flank
pain• Nausea/vomiting• Severe colicky back
pain• Lightheadedness• Hypertension
• Hematuria• Severe flank pain• Abdominal pulsating
mass• Severe abdominal
pain• Severe back pain• Hypertension• Syncope• Shock (late sign)
Kidney stones AAA
What to do.
Address pain relief Hydration Draw blood (R/O renal function, infection,
or blood loss)
CBC /c differential (checking the white cell count)
Hemoglobin & Hematocrit (H&H)
Platelets
… And?
Chem 7 (Panel 7) - comprehensive metabolic panel to test:
Electrolytes BUN Creatinine
Obtain urine for a urinalysis that will test for: Nitrates Leukocytes blood in the urine
Also, keep in mind that the urinalysis alone doesn’t tell the whole story. Do not conclude that the
patient has a kidney stone just because he has hematuria.
In one study, more than 87% of patients with an AAA also had hematuria.
If facility does not have access to CT, X-ray of kidneys, ureters, & bladder is considered accurate also.
Differentiation …continued
Differentiation …continued
X-rays, can not be performed on pregnant women
probably ultrasound Ultrasound may also
be preformed if the patient is too unstable for transport.
Or trained cardiologist or surgeon can perform a TEE (transesophageal echo) to verify AAA at the bedside.
Differentiation …continued