Which procedure is used to eliminate calculi from the urinary tract?

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-2)

Explanation

Lithotripsy is the specific medical procedure for treating urinary tract calculi (stones) by breaking them into smaller pieces.
It commonly uses focused energy, such as high-energy shock waves (ESWL) or lasers, to fragment the stones.
The resulting smaller fragments are then able to pass naturally out of the body through the urine.
It is a non-invasive or minimally invasive procedure, making it a preferred method for stone elimination compared to open surgery.

Option A: Cystotomy is a surgical incision into the bladder. It is an invasive procedure and not the general term or primary method for eliminating most urinary tract stones.
Option B: Cystoscopy is primarily a diagnostic procedure to visualize the inside of the bladder and urethra. It does not involve breaking up stones.
Option D: Nephrectomy is the surgical removal of a kidney. This is a radical treatment and is not performed for the purpose of eliminating stones.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical and procedural management of urolithiasis (urinary stones) as background academic context rather than a clinical decision trigger.
A key nursing responsibility after lithotripsy is to strain all the patient's urine. This is critical for collecting stone fragments for analysis to identify the cause and guide prevention strategies.
Encouraging high fluid intake (2-3 liters per day, if not contraindicated) is essential to help flush out the stone fragments and prevent the formation of new stones.
Nurses must monitor for complications such as persistent severe pain, fever, chills, or decreased urine output, which could indicate a urinary tract infection or obstruction from stone fragments.

How to Approach the Question

First, identify the key terms in the question: 'eliminate calculi' (remove stones) and 'urinary tract'.
The question asks for the specific procedure used for this purpose.
Next, define each of the options in your mind.
Cystotomy: 'otomy' means to make an incision into. So, an incision into the bladder.
Cystoscopy: 'scopy' means to look. So, looking into the bladder.
Lithotripsy: 'litho' means stone, and 'tripsy' means to crush. So, crushing stones.

Concept Tested & Keywords

Concept Tested: Surgical and procedural management of urolithiasis (urinary stones).
Stem keywords: procedure, eliminate calculi, urinary tract
Lead-in keywords: Which

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1118-1120

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