Professional Documents
Culture Documents
Urolithiasis
Urolithiasis
Calcium stones
Idiopathic hypercalciuria
Hyperuricosuria
Primary hyperparathyroidism
Distal renal tubular acidosis (hereditary)
Intestinal hyperoxaluria
Hereditary hyperoxaluria
Hypercitraturia
Idiopathic stone disease
RISK FACTORS
Inadequate fluid intake
Climate
Excess intake of vitamin d & primary
hyperparathyroidism
Immobilization
Family history
Genetic influences
Diet (protein rich, calcium rich and low fluid
intake)
risk factors
Arthritis (painful joint inflammation)
Colitis (inflammation of the colon that causes
CNTD
Hypertension (high blood pressure)
Hyperparathyroidism (excessive parathyroid
TYPES OF STONES
Calcium oxalate stones:
Calcium phosphate stones
Struvite stones
Uric acid stones:
Cystine stones
Xanthine stones
SHAPE OF STONES
PATHOGENESIS
OF
SUPER SATURATION
STONES
equilibrium solubility product.
metastably super saturated
upper limit of metastability
CNTD..
NUCLEATION:
Homogenous Nucleation
Heterogeneous Nucleation
INHIBITORS OF CRYSTAL FORMATION
RENAL COLIC
CLINICAL
URETERIC COLIC
MANIFESTATIONS
HEMATURIA
DYSURIA
NAUSEA
VOMITING
FEVER WITH CHILLS
S/S SHOCK
COMPLICATIONS
Decrease or loss of function in
INVESTIGATIONS:
Urine analysis: RBC in urine represents direct
CNTD..
CT scan: Identifies location and size of
obstruction.
Ultra Sonography.
Cystoscopy.
Blood urea Nitrogen and serum creatinine
levels are high.
A careful history including previous stone
formation, medication, family history of urinary
calculi.
MANAGEMENT
Pain management
Adequate hydration
Treatment and control of
infection
Drug therapy
Dietary restrictions
Purine rich foods: Sardines, meat soups,
ESWL
SURGICAL MANAGEMENT
Indications for open surgical stone removal
include
Stones too large for spontaneous passage.
Stones associated with bacteriuria or
symptomatic infection
Stones causing impaired renal function
Stones causing persistent pain, nausea or ileus
Inability of patient to be treated medically
Patient with one kidney
ENDOUROLOGIC
PROCEDURES
Cystoscopy: If the stone is located in the bladder
Cystolitholapaxy: Large stones are broken up
CNTD..
PERCUTANEOUS NEPHROLITHOTOMY
(PCNL)
LITHOTRIPSY (ESWL)
OPEN SURGICAL
APPROACHES
Nephrolithotomy
Pyelolithotomy
Ureterolithotomy
Cystotomy
NURSING DIAGNOSES
Pain during micturition rlt the presence of
PREVENTION
MEASURES
Adequate hydration
Dietary restrictions of purines, oxalate and