A graduate nurse has joined the staff in the care of renal patients. The graduate asks the preceptor to discuss the risks for urinary calculi. The nurse identifies which of the following clients as having the greatest risk for urinary stones?
1. 70-year-old male with a recent history of myocardial infarction
2. 45-year-old female with paraplegia from an auto accident
3. 60-year-old male with type II diabetes mellitus
4. 30-year-old female with several episodes of urinary infection
2. 45-year-old female with paraplegia from an auto accident
Rationale:
The 45-year-old female with paraplegia from an auto accident experiences prolonged immobility, which will increase calcium loss from bones and therefore increase the chance of calcium stones precipitating in the urinary system. A 70–year-old male with a recent history of myocardial infarction, 60-year-old male with type II diabetes mellitus, and 30-year-old female with several episodes of urinary infection do not have as great a risk because they do not remain immobile for long periods of time.
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