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Urolithiasis therefore has a significant impact on quality of life and socioeconomic factors. Definition Urolithiasis refers to stones calculi in the urinary tract.
Stones are formed in the urinary tract when urinary concentrations of substances such as calcium oxalate, calcium phosphate, and uric acid increase. Causes of hypercalcemia high serum calcium and hypercalciuria high urine calcium are: Hyperparathyroidism Renal tubular acidosis Cancers Granulomatous diseases sarcoidosis, tuberculosis , which may cause increased vitamin D production by the granulomatous tissue Excessive intake of vitamin D Excessive intake of milk and alkali Myeloproliferative diseases.
Stones can be classified according to anatomical position: upper, middle or lower calyx; renal pelvis; upper, middle or distal ureter; and urinary bladder. Signs and symptoms of stones in the urinary tract depend on obstruction, infection, and edema. Diarrhea Abdominal discomfort. The diagnosis is confirmed by x-ray films of the kidneys, ureter, and bladder KUB or by ultrasonography, intravenous urography IVU , or retrograde pyelography, and noncontrast enhanced computed tomography NCCT.
Treatment The basic goals of management : To eradicate the stone To determine the stone type To prevent nephron destruction To control infection To relieve any obstruction that may be present To relieve the pain until its cause can be eliminated.
Indications for active removal of ureteral stones: Stones with low likelihood of spontaneous passage Persistent pain despite adequate analgesic medication Persistent obstruction Renal insufficiency renal failure, bilateral obstruction, or single kidney.
Indications for active removal of kidney stones: Stone growth Stones in high-risk patients for stone formation Obstruction caused by stones Infection Symptomatic stones e. Nursing Care Nursing Diagnosis: Acute pain related to inflammation, obstruction, and abrasion of the urinary tract Deficient knowledge regarding prevention of recurrence of renal stones Potential Complications: Infection and sepsis from UTI and pyelonephritis Obstruction of the urinary tract by a stone or edema with subsequent acute renal failure.
The major goals for the patient may include relief of pain and discomfort, prevention of recurrence of renal stones, and absence of complications. Nursing interventions: relieving pain, monitoring and managing potential complications, teaching patients selfcare. Expected patient outcomes may include: Reports relief of pain States increased knowledge of health-seeking behaviors to prevent recurrence 1.
Consumes increased fluid intake 2. Participates in appropriate activity 3. Consumes diet prescribed to reduce dietary factors predisposing to stone formation 4. Recognizes symptoms to be reported to health care provider fever, chills, flank pain, hematuria 5. Monitors urinary pH as directed 6. Takes prescribed medication as directed to reduce stone formation. Experiences no complications 1. Reports no signs or symptoms of sepsis or infection 2.
Voids normal urine productions without evidence of bleeding 3. Experiences absence of dysuria, frequency, and hesitancy 4. Maintains normal body temperatur. References Knoll, T.
Epidemiology, pathogenesis, and pathophysiology of urolithiasis. European Urology Supplements ; Ratu, G. The analysis of urethral stone profile at the clinical pathology laboratory.
Smeltzer, S. Turk, C. Guidelines on Urolithiasis. European Association of Urology. Learn more about Scribd Membership Home. Much more than documents. Discover everything Scribd has to offer, including books and audiobooks from major publishers. Start Free Trial Cancel anytime. Uploaded by arum. Document Information click to expand document information Description: ppt. Date uploaded Dec 15, Did you find this document useful? Is this content inappropriate? Report this Document. Description: ppt.
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ASUHAN KEPERAWATAN UROLITHIASIS 2018