SEKOLAH TINGGI

KEPERAWATAN
ILMU KESEHATAN

BUANA HUSADA ENGLISH FOR HEALTH

PONOROGO SCIENCE

Day/Date : Saturday / 13th of June 2015 Semester : II

Lecturer : KRMP Bangkit Susanto H, S.Pd, MM Character : Opened

Name : Theodoric Cahyo Pangestu Time : 08.00-09.40 WIB

CHAPTER I

INTRODUCTION

A. Background

Government as the highest group in public health efforts has tried to

improve the level of public health. This also applies to kidney stones or

Urolithiasis , in recent years the government has been helping people with

Urolithiasis to ease the cost of their treatment and healing, but the government

should try to prevent the disease do not cure the patient like above.

It would be more effective if we prevent than to cure. I take on this theme

in the context of prevention urology, because in the area where I live, many

people have kidney stones. With the abundance of limestone mountains in the

area where I live it’s double the chance of developing kidney stones. Plus the lack

of knowledge from people’s about the dangers of drinking water with a high lime

content worsened the situation.

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 The government should focus more on things like socialization in

vulnerable areas such as the area where I live. It would be more effective in

lowering the lowering chance people’s get urolithiasis. I create this study case is

one of effort to prevent the urolithiasis. I make this case study is one socialization

for people in the case of urolithiasis. I also hope readers understand if there is

some mistake in this case study.

B. Problem Formulation

1. What's that urolithiasis disease?

2. How many types of urolithiasis?

3. What causes urolithiasis?

4. How to treat the patients with urolithiasis?

C. Purpose

1. To know about urolithiasis.

2. To know the types of urolithiasis.

3. The prevention of urolithiasis.

4. To know treatment for patients with urolithiasis.

D. Advantage

1. For students

a. Increase knowledge about urolithiasis.

b. To know how to take care kidney urolithiasis.

c. Can prevent themselves from urolithiasis.

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2. For patients

a. To know about the patient's illness.

b. Know how to take care of themselves with the disease.

c. Increase the spirit of the patient to recover.

3. For institutions

a. Input the Institution of urolithiasis disease.

b. Input for the institution of treating patient’s urolithiasis.

c. For reference in researcher.

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 CHAPTER II

DISCUSSION

A. DISCUSSION

1. Definition

A kidney stone, also known as urolithiasis, is a solid piece of

material which formed in the kidneys from minerals in

the urine. Urolithiasiss typically leave the body in the urine stream, and a

small stone may pass without causing symptoms. If stones grow to

sufficient size (usually at least 3 millimeters (0.12 in)) they can cause

blockage of the ureter. This leads to pain, most commonly beginning in

the flank or lower back and often radiating to the groin. This pain is often

known as renal colic and typically comes in waves lasting 20 to 60

minutes. Other associated symptoms

include: nausea, vomiting, fever, blood in the urine, pus in the urine,

and painful urination. Blockage of the ureter can cause decreased kidney

function and dilation of the kidney.

Most stones form due to a combination of genetics and

environmental factors. Risk factors include being overweight, certain

foods, some medications, and not drinking enough fluids. The diagnosis is

usually based and symptoms, urine testing, and medical imaging. Blood

tests may also be useful. Urolithiasis stones are typically classified by

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 their chemical composition (calcium-containing, struvite, uric acid, or

other compounds).

In those who have previously had stones, prevention is recommended by

drinking fluids such that more than two liters of urine is produced per day.

If this is not effective enough, thiazide diuretic, citrate or allopurinol may

be taken. It is recommended that soft drinks containing phosphoric

acid (typically colas) be avoided

2. Etiology

a. Factors that may increase your risk of urolithiasiss include:

1) White adult male under 50 years old

2) Personal history of urolithiasiss

3) Family history of urolithiasiss

b. Other factors that increase your risk of urolithiasiss include:

1) Calcium oxalate or phosphorus stones:

a) Excess dietary sodium and oxalate. Oxalate can be found in

green, leafy vegetables, chocolate, nuts, or tea.

b) Low fluid intake, especially during warmer weather, which can

lead to dehydration

c) Overactive parathyroid gland

d) Chronic bowel disorders such as Crohn’s disease or ulcerative

colitis

e) Some diuretics

f) Calcium-based antacids

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 2) Struvite stones:

a) History of urinary infection

b) More common in women

3) Uric acid stones:

a) Excess dietary red meat or poultry

b) Gout

4) Cystine stones

a) A rare genetic disorder increases the risk of cystine stones.

3. Symptom of Urolithiasiss

People with urolithiasiss may have pain while urinating, see blood

in the urine, or feel a sharp pain in the back or lower abdomen. The pain

may last for a short or long time. People may experience nausea and

vomiting with the pain. However, people who have small stones that pass

easily through the urinary tract may not have symptoms at all.

4. Type of Urolithiasiss

a. Calcium stones are the most common type of urolithiasis and occur in

two major forms: calcium oxalate and calcium phosphate. Calcium

oxalate stones are more common. Calcium oxalate stone formation may

be caused by high calcium and high oxalate excretion. Calcium

phosphate stones are caused by the combination of high urine calcium

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 and alkaline urine, meaning the urine has a high pH. In the early 1990s,

a study conducted for the Women's Health Initiative in the US found

that postmenopausal women who consumed 1000 mg of supplemental

calcium and 400 international units of vitamin D per day for seven

years had a 17% higher risk of developing urolithiasiss than subjects

taking a placebo. The Nurses' Health Study also showed an association

between supplemental calcium intake and urolithiasis formation.

b. Uric acid stones form when the urine is persistently acidic. A diet rich

in purines—substances found in animal protein such as meats, fish, and

shellfish—may increase uric acid in urine. If uric acid becomes

concentrated in the urine, it can settle and form a stone by itself or

along with calcium.

c. Struvite stones result from kidney infections. Eliminating infected

stones from the urinary tract and staying infection-free can prevent

more struvite stones.

d. Cystine stones result from a genetic disorder that causes cystine to leak

through the kidneys and into the urine, forming crystals that tend to

accumulate into stones.

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B. TREATMENT

1. Pharmacology

a. Medicine to help pass stones

Medicine you can buy without a prescription, such as

nonsteroidal anti-inflammatory drugs (NSAIDs), may relieve your

pain while you pass a stone.Your doctor may also prescribe medicine

to help your body pass the stone, such as alpha-blockers.

b. Medicine to prevent stones :

Which medicine you take depends on the type of stones you

have.

1) Calcium stones

Calcium stones are the most common kind of urolithiasis.

To prevent them, you may take:

a) Orthophosphate.

b) Potassium citrate.

c) Thiazides.

2) Uric acid stones

Some urolithiasiss are made of uric acid, a waste product

that normally exits the body in the urine. To prevent these types of

stones, you may take:

a) Allopurinol.

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 b) Potassium citrate.

c) Sodium bicarbonate.

3) Cystine stones

A very small number of stones are made of a chemical

called cystine. Medicines to prevent them include:

a) Penicillamine.

b) Potassium citrate.

c) Tiopronin.

4) Struvite stones

Some struvite stones (staghorn calculi) form because of

frequent kidney infections. If you have a struvite stone, you will

most likely need antibiotics to cure the infection and help prevent

new stones from forming. You may need surgery to remove the

stone. Urease inhibitors may be used to prevent struvite stones.

2. Non- Pharmacology

Surgery is rarely needed to treat urolithiasiss. Surgery is only

needed when the urolithiasis is very large, caused by an infection

(staghorn calculi), blocking the flow of urine out of the kidney, or

causing other problems like severe bleeding.

If your urolithiasiss were caused by a problem with your

parathyroid gland , your doctor may suggest surgery to remove a

parathyroid gland or glands (parathyroidectomy). This can help prevent

futureurolithiasiss.

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3. Rehabilitation

Once you have formed a urolithiasis, you are more likely to form

another. Here are some steps to prevent this condition:

a. Drink plenty of fluids, especially water.

b. Talk to your doctor about what diet is right for you. Depending

on the type of stone you have, you may have to avoid certain

food or drinks.

c. Depending on what type of stone you have, certain medications

may be prescribed to keep stones from forming again.

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 CHAPTER III

CLOSING

A. Conclusion

A kidney stone, also known as urolithiasis, is a solid piece of

material which formed in the kidneys from minerals in the urine. Urolithiasiss

typically leave the body in the urine stream, and a small stone may pass without

causing symptoms. If stones grow to sufficient size (usually at least 3 millimeters

(0.12 in)) they can cause blockage of the ureter this leads to pain typically comes

in waves lasting 20 to 60 minutes.

Most stones form due to a combination of genetics and environmental

factors. Risk factors include being overweight, certain foods, some medications,

and not drinking enough fluids. Urolithiasis stones are typically classified by

their chemical composition (calcium-containing, struvite, uric acid, or other

compounds).There are few way to cure urolithiasis, with medicine or surgery. If

you wants take medicine you should know what type stone you have, because

different type stone need different medicine. Surgery is not always optional

because your doctor will only recommend surgery if your stone is big enough to

block your urethra or there are infection in your kidney.

Once you have formed a urolithiasis, you are more likely to form another.

Here are some steps to prevent this condition:

1. Drink plenty of fluids, especially water.

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 2. Talk to your doctor about what diet is right for you. Depending on

the type of stone you have, you may have to avoid certain food or

drinks.

3. Depending on what type of stone you have, certain medications

may be prescribed to keep stones from forming again.

B. Suggestion

Withthis article Ihope readersknow more aboutkidney stones. weshouldbe

aware ofkidney stones, though not fatalkidney stonesifleft unchecked willlead

tothe kinds ofcomplications of the diseasethatis hazardous. Therefore, letusspread

theknowledgeaboutkidney stonesin peopleso thattheycanavoidcontractingkidney

stones.

1. For patients with urolithiasis I hope by reading this article you all

more cooperative in the process of your treatment and prevent you

re-experience urolithiasis.

2. For students I hope this case study can increase knowledge and

enable you to prevent urolithiasis in yourself, your family and

people’s around you. I also hope that you as readers will spread the

knowledge of Urolithiasisis to prevent people’s from getting

Urolithiasis.

3. For an institution I hope this case study can be in place at the

university library so students and people’s can read and add to their

knowledge. I also hope this case study can be made reverences for

teaching materials about Urolithiasis.

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 BIBLIOGRAPHY

C. A. O’Callaghan. 2011. The Renal Sytem at a Glance. Jakarta :

Penerbit Erlangga

Johri, N; Cooper, B; Robertson, W; Choong, S et al. 2010 . An update

and practical guide to renal stone management: Nephron Clinical
Practice. Switzerland : Karger Publisher

http://www.niddk.nih.gov/health-information/health-topics/urologic-
disease/kidney-stones-in-adults/Pages/facts.aspx#types Access at 24th
of May 2015 07.:45 PM

http://www.rehab.com/For-Patients/Resource-Center/Library/health-
library.aspx?chunkiid=11725 Access at 31 th of May 2015 09.19 PM