This document provides information about kidney stones (nephrolithiasis). It begins with terminology used to describe stones in different parts of the urinary tract. It then discusses the introduction, definition, etiology, types, pathophysiology, clinical manifestations, diagnostic tests, management, prevention, nursing diagnosis, nursing management, complications, and conclusion of kidney stones. The document aims to educate on kidney stones by defining the condition, describing the causes and types, outlining signs and symptoms, discussing treatment options, prevention methods, and potential complications.
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List the signs/symptoms and differential diagnoses of an acute stone episode
Describe the imaging studies available to diagnose ureteral calculi.
List the classes of medications effective for treating the pain of renal colic.
Outline the basic treatment options for ureteral stone
Describe the clinical scenarios requiring urgent decompression of a ureteral stone.
List the basic principles of stone preventi
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Nephrolithiasis refers to stones (calculi) in kidney when urinary concentration of substances such as calcium oxalate, calcium phosphate and uric acid increases, but they can form in or migrate to the lower urinary system. They are typically asymptomatic until they pass into the lower urinary tract.
CHOLELITHIASIS, NEPHROLITHIASIS SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPH...Jack Frost
CHOLELITHIASIS, NEPHROLITHIASIS
SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPHROSIS
This presentation contains real names of persons involve of this particular study. This names should not be copied or rewritten. Used the data of this study as basis only. All rights reserved 2009.
Urolithiasis Is the process of forming stones in the kidney, bladder or urethra
Kidney stones(calculi) are formed of minerals deposits commonly calcium oxalate and calcium phosphate; however uric acid, struvite and cystine are also calculus formers.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
List the signs/symptoms and differential diagnoses of an acute stone episode
Describe the imaging studies available to diagnose ureteral calculi.
List the classes of medications effective for treating the pain of renal colic.
Outline the basic treatment options for ureteral stone
Describe the clinical scenarios requiring urgent decompression of a ureteral stone.
List the basic principles of stone preventi
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Nephrolithiasis refers to stones (calculi) in kidney when urinary concentration of substances such as calcium oxalate, calcium phosphate and uric acid increases, but they can form in or migrate to the lower urinary system. They are typically asymptomatic until they pass into the lower urinary tract.
CHOLELITHIASIS, NEPHROLITHIASIS SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPH...Jack Frost
CHOLELITHIASIS, NEPHROLITHIASIS
SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPHROSIS
This presentation contains real names of persons involve of this particular study. This names should not be copied or rewritten. Used the data of this study as basis only. All rights reserved 2009.
Urolithiasis Is the process of forming stones in the kidney, bladder or urethra
Kidney stones(calculi) are formed of minerals deposits commonly calcium oxalate and calcium phosphate; however uric acid, struvite and cystine are also calculus formers.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
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According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
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Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
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Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
2. TERMINOLOGY
Urolithiasis - Stone in urinary tract
Nephrolithiasis – Stone in kidney
Ureterolithiasis- Stone in ureters ( most painful)
3. INTRODUCTION
A kidney stoneor renal calculi are hard deposits of
minerals or salts , that are forms in kindney and
present in different sizes.
It may occurs due to diet, overweight, some
medical conditions, medication and often occurs
when urine becomes concentrated, allowing
minerals to crystallize and stick together.
Stones may be formed in the kidney, urinary
bladder, ureter and urethra.
4.
5. DEFINITION
1. A kidney stone, also known as a renal calculus or
nephrolithiasis , it is define as calculi formation in
kidney and kidney part .
Acc. To P.K. Panwar
2. Kidney stone / renal calculi is solid mass made up
of crystals present in kidney or ureter.
Acc. To M.P. Sharma
6.
7. ETIOLOGY
Diet pattern –
80% causes of stone.
high in calcium , magnesium , phosphate
Family history
Dehydration
UTI & prolonged catheterization
Other disease of kidney –
Renal failure
Nephritis
Dehydration
Obstruction
8. TYPES
There are mainly five types
1. Calcium oxalate stone (is the most
common 80%)
2. Cystine stone
3. Struvite stone (triple stone)
4. Uric acid stone
5. Others stone
9. 1. CALCIUM OXALATE STONE:-
It is the most common type of renal stones, about
80%.
Calcium stones are the most Common stones
present in urinary tract.
Calcium based stone are most commonly seen
in young men between the age of 20 and 30
years.
It is present in foods such as spinach and vitamin
C supplements and citrus fruits .
10. 2.CYSTINE STONE
Cystine stone is rare can form in people who have
cystinuria . It is cystine is a protein, about 2% of
chance
It can affect both women and men .
(cystine source avoid meat milk, cheese, egg)
11. 3. STRUVITE STONE
These stones are formed of struvite ( Mg amonium
phasphate)
This type of stone is mostly found in women who
have a urinary tract infection.
These stone can grow very large and can block
the kidney, ureter or bladder.
12. 4. URIC ACID STONE
It is second most common type of renal stones
about10%.
This type of stone is more Common in men than
women. They Can occur in individual with gout or
those taking chemotherapy .
14. PATHOPHYSIOLOGY
due to any etiology factor
urine supersaturation
crystal nucleation
crystal growth
crystal aggregation
stone formation
Renal calculi
15. CLINICAL MANIFESTATION
Usually symptoms of kidney stones may not occurs
until the stones reach to the ureters.
Renal colic or severe sharp pain occurs in flank
area , that also radiate to lower abdomen and groin
.
16. Pain or burning sensation while urinating.
Other symptoms –
Pink , red or brown urine.
Cloudy or foul smelling urine.
Uregency of urination ( sudden uncontrollabe, need
to urinate )
Urinating small amounts of urine.
Note _ kidney stones sometimes considered “the
great mimicker” but common their symptoms very
similar to appendicitis , gastritis, UTI, ovarian or
testicular conditions.
17. DIAGNOSTIC TEST
History collection
Physical examination
Blood test ( to check calcium, phosphorus, uric acid and
electrolyte level)
Urinalysis ( to see crystals and look for RBC in urine )
Examine of stone to determine the type of stone or
blockage can be seen on :
Abdominal CT scan
Abdominal / kidney MRI
Abdominal x-ray( less commonly )
USG
Intravenous pyelogram
18.
19. MANAGEMENT- MANAGEMENT OF KIDNEY
STONES DEPENDING ON TYPE OF STONE AND
CAUSE OF STONE .
(A) Small stones with minimal symptoms _
Most small stones not require surgery, these may pass
by-
- drinking enough water ( 2.5- 3.5 lit/day )
Medical therapy – (<5mm treat medicine _ 10mm(50%
chance ), if >10 mm required surgery)
Pain relievers_ ibuprofen, naproxen
Uric acid stones_ allopurinol (zyloprim)
Struvite stones_ antibiotics ( amoxicilline,
cotrimaxazole)
Ca stones_ thiazide diuretics to prevent forming of
Calcium stones.
To relax smooth muscles_ Jolyn (tamsulosin
+dutasteride)
20. (B) LARGE STONES
Extracorporeal shockwave lithiotripsy-
It uses sound waves to create strong vibrations
(shock waves) that break stones into tiny pieces
that can be passed in to urine .
This procedure last about 45- 60 mins
21. (B) NEPHROLITHIOTOMY
In this procedure a incision is made in flank area,
from which a small tube with scope inserted in to
the kidney and removes the stones.
This procedure performed when extracorporeal
shockwave lithiotripsy is unsucessful.
22. (C) URETEROSCOPY
In this procedure, first of all surgeon placed a tube
with camera into ureter by making incision into
bladder.
A small cage is used to snag the stone and remove
it.
23. PREVENTION
Avoid protein intake:-usually protein is restricted to
60 kg/day to decrease urinary excretion of calcium
and uric acid.
A sodium intake :- of 3 to 4 g/day is recommended
table salt and high-sodium foods should be
reduced, because sodium competes with calcium
for reabsorption in the kidneys.
Low calcium diets are not –generally
recommended, except for true absorptive
hypercalcuria evidence shows that limiting calcium,
especially in women can lead to osteoporosis and
does not prevent renal stone.
24. CONT..
Avoid intake of oxalate-containing foods (e.g.
spinach, strawberries, tea, peanuts, wheat bran)
During the day, drink fluids (ideally water) every day
1-2 hours
Drink two glasses of water at bedtime and an
additional glass at each night time awakening to
prevent urine from becoming too concentrated
during the night.
Avoid activities leading to sudden increase in
environmental temperature that may cause
excessive sweating and dehydration.
Contact your primary health care provide at the first
sign of a urinary tract infection.
25. NURSING DIAGNOSIS
1-Acute pain related to obstruction in urine flow.
2-Deficient knowledge related to disease condition.
3-Impaired urinary elimination related to mechanical
obstruction.
4- Risk for infection related to introduction of bacteria
following manipulation of the urinary tract and
obstructed urinary blood flow.
5-Altered daily living pattern related to restlessness
and sudden attack of pain.
26. NURSING MANAGEMENT
Advise the patient at least 6-8 glasses of water per
day to produce a large amount of urine. This will
help to pass the stone.
Instrut to take a low sodium diet.
Advise the patient to avoid the diet high in calcium,
purine and vitamin C.
Monitor urine output, frequency, consistency odour,
volume and colour to evaluate the petency of
urinary system.
Assess the quality, intensity, severity location and
frequency of pain.
27. Advise the patient to change life style pattern.
Advise the patient to avoid prolonged sitting and
standing.
Administer the medications as the prescription.
Check and maintain input and output chart.
Teach the patient that this condition may lead to
urinary tract infection so explain about sign and
symptoms of UTI.
Educate about the proper care of wound if surgical
opening to remove stone.
Use the pain control measure before it become
severe.
28. COMPLICATION
Urinary tract infection.
Kidney damage or scarring (if treatment is delay
for too long)
Obstruction of ureter (acute unilateral obstructive
uropathy).
29. CONCLUSION
Kidney stones can develop as a result of several
factors, including dehydration , the urine become
concentrated and minerals can from crystals that
can ultimately develop into stones.