Nephrolithiasis (kidney stones) — NCLEX Cheat Sheet
Severe colicky flank painAlso known as: kidney stones · renal calculi · stones · urolithiasis · renal stone
Use this quick-reference guide to spot, treat, and prevent Nephrolithiasis (kidney stones) on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- SEVERE colicky flank pain
- radiates groin, hematuria, N/V
- restless, can't find comfort
✅ Do
- STRAIN all urine for stones
- ↑fluids 3 L/day, ambulate
- pain meds, antispasmodics
🚩 Report
- no urine output → obstruction
- fever + pain → infection
🎓 Teach
- calcium stones: limit Na/oxalate
- uric acid: limit purines (organ meat)
- lithotripsy for large stones
📚 Nephrolithiasis (kidney stones) — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Severe, colicky flank pain that may radiate to the groin, testes, or labia is the classic presentation.
- Hematuria (gross or microscopic) is common from stone irritation of the urinary tract.
- Nausea, vomiting, diaphoresis, and restlessness often accompany the pain.
- Dehydration and low fluid intake are major contributing factors.
- Most stones are calcium-based; uric acid, struvite (infection-related), and cystine are other types.
- Obstruction can cause urinary urgency, frequency, and decreased output on the affected side.
Nursing priorities
What to do, in order- Manage pain aggressively - administer prescribed opioids/NSAIDs and antispasmodics promptly.
- Encourage high fluid intake (3 L/day or more) to help pass the stone unless contraindicated.
- Strain all urine to catch the stone for analysis and monitor output.
- Monitor for signs of obstruction and infection; encourage ambulation to aid passage.
- Prepare for lithotripsy or surgical removal if the stone does not pass.
Red flags — report now
Escalate immediately- Fever with the colic - possible infection behind an obstruction; report immediately as a urologic emergency.
- Anuria or no output on the affected side - complete obstruction; escalate.
- Pain unrelieved by prescribed analgesia - report.
- Signs of sepsis from an obstructed, infected system - emergency.
Labs & values
Numbers to know- Urinalysis: hematuria, crystals, possible pyuria
- Serum calcium: normal 9.0-10.5 mg/dL; uric acid as indicated
- Stone analysis: identifies stone type to guide prevention
Patient teaching
What patients must know- Drink at least 3 liters of fluid daily to prevent recurrence.
- Calcium-oxalate stones: limit oxalate foods (spinach, nuts, tea, chocolate); for uric acid stones limit purines (organ meats, red meat).
- Strain urine at home and keep any stone passed for analysis.
❓ Nephrolithiasis (kidney stones): NCLEX FAQs
What are the priority nursing interventions for Nephrolithiasis (kidney stones)?
Manage pain aggressively - administer prescribed opioids/NSAIDs and antispasmodics promptly. Encourage high fluid intake (3 L/day or more) to help pass the stone unless contraindicated. Strain all urine to catch the stone for analysis and monitor output. Monitor for signs of obstruction and infection; encourage ambulation to aid passage.
What are the warning signs of Nephrolithiasis (kidney stones) a nurse must report?
Fever with the colic - possible infection behind an obstruction; report immediately as a urologic emergency. Anuria or no output on the affected side - complete obstruction; escalate. Pain unrelieved by prescribed analgesia - report. Signs of sepsis from an obstructed, infected system - emergency.
What do I need to know about Nephrolithiasis (kidney stones) for the NCLEX?
Severe, colicky flank pain that may radiate to the groin, testes, or labia is the classic presentation. Hematuria (gross or microscopic) is common from stone irritation of the urinary tract. Nausea, vomiting, diaphoresis, and restlessness often accompany the pain. Dehydration and low fluid intake are major contributing factors.
What patient teaching is important for Nephrolithiasis (kidney stones)?
Drink at least 3 liters of fluid daily to prevent recurrence. Calcium-oxalate stones: limit oxalate foods (spinach, nuts, tea, chocolate); for uric acid stones limit purines (organ meats, red meat). Strain urine at home and keep any stone passed for analysis.
Quick Tip
Severe, colicky flank pain that may radiate to the groin, testes, or labia is the classic presentation.
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