Conditions which predispose a person to renal calculi formation include :

IGNOU PB Bsc Entrance-2023

Medical & Surgical Nursing

Easy

Appeared in: IGNOU PB Bsc Entrance-2023

Explanation

Immobility is a major predisposing factor for the formation of renal calculi (kidney stones).
Lack of weight-bearing activity leads to bone demineralization, causing calcium to move from bones into the blood (hypercalcemia) and then into the urine (hypercalciuria).
Immobility also causes urinary stasis, where urine pools in the renal pelvis, allowing stone-forming crystals like calcium to precipitate and form stones.
The combination of high urinary calcium concentration and urinary stasis significantly increases the risk of stone formation.

Option A: Polyuria, or excessive urine output, is protective against stone formation. It dilutes the urine and helps flush out potential stone-forming solutes before they can crystallize.
Option C: Glycosuria (glucose in the urine) primarily increases the risk for urinary tract infections because the sugar provides a nutrient source for bacteria. It does not directly cause the formation of renal calculi.
Option D: A Foley's catheter is a foreign body that can increase the risk of catheter-associated urinary tract infections (CAUTIs) and can become encrusted with mineral deposits. However, it is not a primary systemic cause of stone formation within the kidney itself like immobility is.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for renal calculi formation as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in preventing renal calculi in at-risk patients, particularly those who are immobile.
Key preventative nursing actions include encouraging adequate fluid intake, promoting early and frequent mobilization, and regularly repositioning bed-bound patients to facilitate urine drainage.
What if? If an immobile patient also has a history of gout, the risk for stone formation is even higher. In addition to immobility-related calcium stones, the patient is at risk for uric acid stones. Nursing care must then also focus on dietary purine restriction and monitoring urine pH.

How to Approach the Question

First, identify the core concept of the question, which is the predisposing factors for renal calculi (kidney stones).
Evaluate each option based on your knowledge of renal pathophysiology.
Consider Option A (Polyuria): Recall that increased urine flow dilutes solutes, which prevents stones. Eliminate this option.
Consider Option B (Immobility): Think about the physiological effects of being bedridden. Recall that it causes bone calcium loss (hypercalciuria) and poor urine drainage (stasis). Both are major risk factors for stone formation. This is a strong candidate.
Consider Option C (Glycosuria): Connect this to diabetes and recall its primary urinary complication is infection, not stones. Eliminate this option.
Consider Option D (Foley's catheter): Associate this with infection and local encrustation, not a primary cause of stones forming in the kidney. Eliminate this option.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor p. 316-318