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    Disorders of Urinary System Urinary Calculi

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    Disorders of Urinary System Urinary Calculi

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    FreeNursingNotes
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    2K views5 pages

    Disorders of Urinary System Urinary Calculi

    Uploaded by

    FreeNursingNotes
    hi there! if you have questions, please email me> [email protected].. Please SUBSCRIBE TOO! thanks!

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    of 5

    Disorders of Urinary System Urinary Calculi

    Etiology

    1. formation of stones in the urinary tract


    2. causes obstruction, infection, and hydronephrosis

    Findings

    Subjective

    1. pain in kidney area – radiates to the flank and pubic area


    2. frequency, urgency to void
    3. nausea and Hx of prior associated health problems

    Objective

    1. diaphoresis
    2. vomiting
    3. grimacing
    4. hematuria, dysuria, pyuria
    5. fever

    Interventions

    1. analgesics as ordered
    2. antispasmodics to reduce renal colic
    3. allopurinol and allopurinol Na
    4. antibiotics to reduce infection
    5. fluids – 3000 ml/day
    6. diet according to type of renal calculi (kidney stone)
    7. strain all urine

    Types of Calculi / Stone

    1. Calcium Stone

    Diet
    - low Ca and P diet
    - eliminate dairy products
    - acid ash diet
    - encourage cranberry juice, vegetables, fruits, Vit C

    2. Oxalate Stone

    Diet
    - avoid oxalate rich foods

    3. Uric Acid Stone

    Diet
    - avoid purine rich foods
    - alkaline ash diet

    4. Cystine Stone

    Diet
    - limit protein rich foods
    - alkaline ash diet

    Surgical Intervention

    1. Nephrolithotomy, Ureterolithotomy, Cystolithotomy


    2. Percutaneous Ultrasonic Lithotripsy (PUL)
    3. Laser lithotripsy
    4. ESWL Extracorporeal shockwave lithotripsy (non-invasisve)

    Nursing Care

    1. monitor VS
    2. fluid intake 3000-4000 ml daily
    3. encourage client to monitor diet as ordered
    4. encourage weight bearing exercise if not contraindicated
    5. change dressings frequently during 1st 24 hours after nephrolithotomy
    6. maintain patency of urethral catheter to prevent hydronephrosis

    Prevention

    1. increase fluid intake


    2. diet

    Acute Renal Failure

    Etiology

    1. d/t trauma to kidneys or overwhelming physiologic stress


    2. sudden loss of renal function
    3. may cause death

    Findings

    Subjective
    - irritability
    - headache
    - anorexia
    - tingling of extremities
    - lethargy or drowsiness

    Objective
    - uriniferous breath and perspiration odor
    - uremic frost
    - anemia
    - hypocalcemia
    - destruction of RBC, WBC, Platelets

    Stages of Acute Renal Failure (ARF)

    Olliguric Phase

    - decreased urine output


    - increased BUN, creatinine
    - edema, HPN
    - hyperkalemia
    - hyponatremia
    - metabolic acidosis
    - lasts 1 to 3 weeks

    Diuretic Phase

    - increased urine output


    - initially BUN, creatinine, BP are elevated (normalize later on)
    - hypokalemia
    - lasts 1 week

    Recovery Phase

    - takes 3 to 12 months
    - avoid nephrotoxic drugs

    Intervention

    1. fluid control
    2. electrolyte control
    3. AB to prevent infection
    4. complete bed rest (CBR)
    5. peritoneal dialysis and hemodialysis

    Nursing Care
    1. monitor VS and I/O of fluids
    2. promote rest
    3. provide skin care

    Chronic Renal Failure

    Etiology

    1. occurs as a result of chronic kidney infection, abnormalities, vascular d/o, and


    destruction of kidney tubules
    2. continuous deterioration in renal function results in uremia

    Findings

    Subjective
    1. lethargy, drowsiness
    2. headache, nausea, pruritus

    Objective
    1. oliguria or anuria
    2. anemia
    3. HPN and Anasarca
    4. uremic frost
    5. hypocalcemia
    6. metabolic acidosis
    7. hyperkalemia
    8. renal osteodystrophy
    9. kussmaul’s respiration

    Stages of Chronic Renal Failure

    Normal adult GFR is 100-120 ml/min (1.67 to 2.0 ml/sec)

    Renal Impairement (Char by GFR 40-50%)


    Renal Insufficiency (GFR 20-40%)
    Renal Failure (GFR 10-20%)
    End Stage Renal Disease (ESRD) (GFR <10%)

    Benign Prostatic Hypertrophy

    Etiology

    1. slow enlargement of the prostate


    2. constricts urethra and interferes w/ urination
    3. may be d/t hormonal imbalances
    Findings

    1. frequency, urgency
    2. difficulty initiating stream
    3. feeling of incomplete emptying of bladder
    4. nocturia and hematuria
    5. decreased force of stream
    6. urinary retention

    Interventions

    1. relief of obstruction by insertion of indwelling catheter


    2. admin Finasteride (PROCAR)
    3. Terazosin (Hytrin) Alpha 1 adrenergic receptor blocker

    Surgical Procedures

    Transurethral Resection of the Prostate (TURP)


    - no incision
    - resectoscope is inserted through the urethra
    - no incontinence, impotence postop

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