Presence of stones in the urinary system

Formation of urinary stones; urinary calculi formed in the ureters.

If the obstruction is not removed, urinary stasis results in infection, impairment of renal function on the side of the blockage and irreversible kidney damage.

High protein intake High solute concentration Hypercalciuria High calcium intake Vitamin A deficiency Dehydration Immobility

Deep ache in costovertebral region Pain radiating to thighs Hematuria/pyuria Renal colic Pain, tenderness, nausea, vomiting

1. KUB radiograph reveals visible calculi.

2. IVP (Intravenous Pyelogram) determines size and location of calculi.

3. Renal Ultrasonography reveals obstructive

changes.

Surgical therapy: 1.Nephrolithomy- incision into the kidney to

remove the stone.

2.Pyelolithotomy- incision into the renal pelvis to remove the stone.

3.Ureterolithotomy-removal of stone in the ureter.

4.Cystotomy- indicated for bladder calculi.

Lithotripsy (ESWL)

- procedure used to eliminate calculi in the kidney. Hematuria is common after the procedure. A stent is often placed after the procedure to promote passage and to prevent obstruction, then removed 1 to 2 weeks after lithotripsy.

Force fluids up to 3000 mL/day, unless contraindicated-to facilitate the passage of the stone & prevent infection.

Strain all urine for the presence of stones.

Turn and reposition immobilized clients.

Monitor intake of fluid amount and urinary output.

Medicate for pain as prescribed.

Continue antibiotic therapy as prescribed.

Correct diet to include reduced protein and calcium content.