Urinary calculi refers to stones formed in the urinary tract from crystallization of substances in urine. Common causes include dehydration, poor fluid intake, immobility, and excess vitamin D or calcium intake. Symptoms include pain at the site of blockage, cystitis, fever, nausea, and abdominal discomfort. Nursing interventions focus on pain control, encouraging fluid intake, and educating patients on prevention of recurrent stones based on their specific type of calculi. Treatment options depend on the size and location of the stones and may include shock wave lithotripsy, surgery, or managing underlying causes.

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