NCLEX Review & Nursing School

Urinary Calculi/ Urilithiasis

URINARY CALCULI is also called urilothiasis or KIDNEY STONES, and it can results from anything from immobility, cancer, increased intake of Vitamin D, or an overactivity of the Parathyroid gland.  

Kidney stones is made up of:

• calcium
• magnesium
• phosphorus
• oxalate.

– High urine acidity or alkalinity contributes to stone formation.
SYMPTOMS (Urinary Calculi)

• Flank pain
• fever
• nausea and vomiting
• changes in the urinary output.

   *** There will be an increase in RBC’s, WBC’s and bacteria.

DIAGNOSTIC TESTS for urinary calculi would include x-ray, blood tests and a 24 hour urine test.

INTERVENTIONS:

Non Surgical Management:

– ↓  Incudes the use of laser to break the stone fragments

 (Extracorporeal shock wave lithotripsy (ESWL).

• patient is given a local anesthetic .
• pt. is placed in a water bath or on a soft cushion.
• shock waves are transmitted through the stones inside the kidney.
• shock waves cause the calculi to break up into smaller pieces.

• * Encourage fluid intake after the procedure.
• * Assess for any hemorrhage

Discharge Teaching (DIET) *Know for NCLEX:

If Uric Acid Stone:

• Alkaline Ash & Low Purine Diet (limit wine, cheese & meat)
• Give Allopurinol as prescribed

If Calcium Stone:

• Calium Restricted Diet (Limit Dairy Foods)

Surgical Interventions:
– Uretherolithotomy

– Nephrolithotomy

• Removal of  renal calculi using a nephroscope.