Nursing care for patients with Urolithiasis

1. Nursing care for patients with Urolithiasis

3. Urolithiasis: • 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.

4. Causes /Predisposing Factors: • High protein intake • High solute concentration • Hypercalciuria • High calcium intake • Vitamin A deficiency • Dehydration • Immobility

5. Clinical Manifestations/Assessment: • Deep ache in costovertebral region • Pain radiating to thighs • Hematuria/pyuria • Renal colic • Pain, tenderness, nausea, vomiting

6. Diagnostics: • 1. KUB radiograph reveals visible calculi. • 2. IVP (Intravenous Pyelogram) determines size and location of calculi. • 3. Renal Ultrasonography reveals obstructive changes.

8. Treatment: • Surgical therapy: • Nephrolithomy- incision into the kidney to remove the stone. • Pyelolithotomy- incision into the renal pelvis to remove the stone. • Ureterolithotomy-removal of stone in the ureter. • Cystotomy- indicated for bladder calculi.

9. Treatment: • 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.

10. Nursing Inteventions: • 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.

11. Nursing Inteventions: • 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.

12. Thank You