The client with urolithiasis has a history of chronic urinary tract infections. The nurse concludes that this client most likely has which of the following types of urinary stones?
A. Calcium oxalate
B. Uric acid
C. Struvite
D. Cystine
Correct Answer: C. Struvite
Struvite stones commonly are referred to as infection stones because they form in urine that is alkaline and rich in ammonia, such as with a urinary tract infection. Struvite stones are also known as triple-phosphate (3 cations associated with 1 anion), infection (or infection-induced), phosphatic, and urease stones.
Option A: Calcium oxalate stones result from increased calcium intake or conditions that raise serum calcium concentrations. Other, less common staghorn calculi can be composed of mixtures of calcium oxalate and calcium phosphate.
Option B: Uric acid stones occur in clients with gout. Uric acid stones form when the levels of uric acid in the urine is too high, and/or the urine is too acidic (pH level below 5.5) on a regular basis. Uric acid can result from a diet high in purines, which are found especially in animal proteins such as beef, poultry, pork, eggs, and fish. The highest levels of purines are found in organ meats, such as liver and fish.
Option D: Cystine stones are rare and occur in clients with a genetic defect that results in decreased renal absorption of the amino acid cystine. Cystine stones are caused by a rare disorder called “cystinuria.” The disorder causes a natural substance called “cystine” to leak into the urine. When there is too much cystine in the urine, kidney stones can form.
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