Renal Calculi – Kidney stones,Causes of kidney stones,treatment for kidney stones

Nursing

Renal Calculi

A small, hard deposit that forms in the kidneys and is often painful when passed.

Kidney stones are hard deposits of minerals and acid salts that stick together in concentrated urine. They can be painful when passing through the urinary tract, but usually don’t cause permanent damage.

Classification

Urolithiasis and nephrolithiasis

Causes

* Urinary stasis

* Super saturation of urineRisk factors

* Immobility

* Sedentary life style

* Dehydration

* Metabolic disturbances

* Increases calcium

* A diet high in purine oxalates calcium and animal proteins

Signs & Symptoms

* Renal colic or ureteric colic

* Sharp severe pain originates deep in the lumbar region and radiate around the sides and down towards the genital or thigh

* Nausea

* Vomiting

* Pallor

* Increased blood pressure and pulse

* Urgency and frequency of urine

* Hematuria

* Fever and chills

Investigations

* USG – Abdomen

* Intravenous pyelogram

* X- ray KUB (Kidney, Urethra, Bladder) or CT KUB

* Blood test may shows increased WBC, uric acid, serum Calcium and Phosphorous

*Cystoscopy

Management

Medical management

* Pain management

* Analgesics and anti spasmodic drugs

* Hydration with oral fluids and IV fluids

* Minimize the calculus formation by dietary changes (less calcium diet)

Surgical Management

* URSL (Ureteroscopic Lithotripsy)

* Intra corporeal Lithotripsy (crushing the stones)

* Laser lithotripsy

* ESWL (extracorporeal shock wave lithotripsy)

* PCNL (Percutaneous Nephrolithotomy)

* Ureterolithotomy

* Cystolithotomy

* Nephrolithotomy

* Nephrectomy

Nursing Management

* Pain control

* Minimize the vomiting by antiemetics

* Increased fluid intake and relaxation technique

* Provide comfortable position

* Maintain fluid intake chart (intake output)

* Advice dietary modification

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