urinary calculai

2. URINARY CALCULI
 ZAREENA KHATOON
 G- Bsn sem 3rd
 I.C.O.N
 Mr. Rafique sial
 Date : 25 –jan-2017

3. objective
 Define urinary calculi
 Pathophysiology of urinary calculi
 Causes and influence factors
 Symptoms of urinary calculi
 Nursing intervention of urinary calculi
 Prevention of recurrent stone formation

4. Urinary Calculi
 It is refer to the presence of stone in urinary system
 Stones, or calculi, are formed in the urinary tract form
the kidney to bladder by the crystallization of
substance excreted in the urine .

6. BLADDER STONE

11. Causes and influence factor:
 Chronic dehydration
 Poor fluid intake
 Immobility
 Excessive intake of vitamin D, milk
 Hypocalcemia, and hypercalemia(calcium level in
blood)

12. Symptoms
 Pain pattern on site of blockage
 Cystitis (inflammation of bladder)
 Chills and fever
 Nausea , vomiting ,diarrhea ,abdominal discomfort


13. Nursing interventions
 Controlling pain
 Give opioid analgesic phenazopyridine (usually IV or
IM) until cause of pain can be remove.
 Encourage patient to assume position that brings
some relief.
 Reassess pain frequently.
 Administer antiemetic's (IM or rectal suppository) as
indication for nausea an vomiting.

14. Prevention of recurrent stone
formation:

for patient with calcium oxalate stones:
 Instruct on diet – avoid excess of calcium and
phosphorus; maintain a law sodium diet
 Teach purpose of drugs therapy – thiazide diuretics to
reduce urine calcium excretion

15. For patient with uric acid stones
 Teach methods to alkalinize urine to enhance urate
solubility
 Instruct on testing urine PH
 Provide information about reducing of dietary purine
intake low protein (red ,fish,)

16. For patient with infection stone
 Teach sings and symptoms of urinary infection:
encourage him to report infection immediately; must
be treated vigorously .
 Try to avoid prolonged periods of recumbency

17. For all patient with stone disease
 Explain need for consistently increased fluid
increase
 Lower the concentration of substance involved in
stone formation.

18. Management
 If small stone and able to treat as output 80% will
pass stone spontaneously with hydration pain control,
 Hospitalize for intractable pain persistence vomiting
,high great fever, obstruction and solitary kidney with
infection.

19. TREATMENT
 Treatment the causes
 Bladder outflow obstruction
 Incomplete bladder empty in patient with neurogenic
bladder dysfunction
 Modalities
 Lithotripsy
 Per cutaneous suprapubic litholapaxy
 Remove of retained foleys catheter

20. CONT…
 Transurethral cystolitholapaxy. A transurethral is the
most common procedure used to treat adult with
bladder stone
 Percutaneous suprapubic cystolitholapaxy
 Open cystostomy
 Complication of surgery
 Recovery and fllow-up
 Treating the underlying cause