 Presence of stones in the urinary system  Formation of urinary stones; urinary calculi formed in the ureters.  If the obstruction is not removed, urinary stasis results in infection, impairment of renal function on the side of the blockage and irreversible kidney damage.

 High protein intake  High solute concentration  Hypercalciuria  High calcium intake  Vitamin A deficiency  Dehydration  Immobility

 Deep ache in costovertebral region  Pain radiating to thighs  Hematuria/pyuria  Renal colic  Pain, tenderness, nausea, vomiting

 1. KUB radiograph reveals visible calculi.  2. IVP (Intravenous Pyelogram) determines size and location of calculi.  3. Renal Ultrasonography reveals obstructive changes.

 Surgical therapy: 1. Nephrolithomy- incision into the kidney to remove the stone. 2. Pyelolithotomy- incision into the renal pelvis to remove the stone. 3. Ureterolithotomy-removal of stone in the ureter. 4. Cystotomy- indicated for bladder calculi.

 Lithotripsy (ESWL) - procedure used to eliminate calculi in the kidney. Hematuria is common after the procedure. A stent is often placed after the procedure to promote passage and to prevent obstruction, then removed 1 to 2 weeks after lithotripsy.

 Force fluids up to 3000 mL/day, unless contraindicated-to facilitate the passage of the stone & prevent infection.  Strain all urine for the presence of stones.  Turn and reposition immobilized clients.

 Monitor intake of fluid amount and urinary output.  Medicate for pain as prescribed.  Continue antibiotic therapy as prescribed.  Correct diet to include reduced protein and calcium content.