Urolothiasis

Question 1

Etiology of urolithiasis

Answer 1

Metabolic, meds, climate, diet, genetics, lifestyle, hypercalcemia , hyperuricemia (gout), men

-must have Vit D c calcium in order for calcium to be absorbed into digestive tract & not formed into calculi

Question 2

Patho of calculi

Answer 2

• slow urine flow causing accumulation of Urine c Calcium
• becomes crystallized & turns into calculi
• it occludes ureter & blocks flow of urine
• ureter dilates & enlargement of ureter (hydronephrosis- swelling of kidney d/t buildup of urine)
• increase risk of permanent kidney damage

Question 3

Clinical manifestations of urolithiasis

Answer 3

• severe pain (flank region suggests stone in kidney or upper ureter)
• flank pain radiating to abd or scrotum (calculi in ureter or bladder)
• sweating, N/V, grey facial colour
• pallor
• bladder distension
• elevation of VS (BP decease if in shock)

Question 4

Diagnostics of calculi - urolithiasis

Answer 4

• urinalysis
• CBC(wbc -infection)
• x Rays
• renal ultrasound
• serum calcium, phosphate, uric acid

Question 5

Assessment of pt with urolithiasis

Answer 5

Hx

• personal or family of calculi
• diet, fluid intake
• if previous stone ask past Tx, chemical analysis of stone ?
• preventive measures

Question 6

Nursing management of pt with urolithiasis

Answer 6

• pain management
• prevent infection & obstruction (antibiotics)
• increase fluids (2-3 L)
• expel stone & collect to test

CAM therapies

• relaxation
• straining of urine
• lithotripsy: use of sound, laser, shock wave energies to break calculi into smaller fragments

Question 7

Surgical management for pt with urolithiasis

Answer 7

• stunting (tube placed into ureter)
• retrograde ureteroscopy (removal of stone from ureter)
• percutaneously ureterolithotomy & nepheolithotomy (passage of needle into collecting systems of kidney, sound or laser to break stone, stone withdrawn, nephrostomy tube left in place to prevent stone fragments passing through urinary tract)

Question 8

Define urolithiasis

Answer 8

Presence of calculi within the urinary tract

-often a symptomatic until calculi pass into lower tract=pain