CUES/ MEDICAL

IMPRESSION
Subjective cues:
masakit talaga
kapag umihi tapos
paminsan konti
lang ihi ko. As
verbalized by the
patient
Objective cues:
Pain scale of 8
Cause: Dx of
Stornhog Calculi

ANATOMY OF THE
ORGAN INVOLVE

NORMAL FUNCTIONS

PATHOPHYSIOLOGY

The kidneys are a pair

of organs located in
the back of the
abdomen. Each
kidney is about 4 or 5
inches long -- about
the size of a fist.
The kidneys' function
are to filter the blood.
All the blood in our
bodies passes through
the kidneys several
times a day. The
kidneys remove
wastes, control the
body's fluid balance,
and regulate the
balance of
electrolytes. As the
kidneys filter blood,
they create urine,
which collects in the
kidneys' pelvis -funnel-shaped
structures that drain
down tubes called
ureters to the bladder.
Each kidney contains
around a million units
called nephrons, each
of which is a

ASSESSMENT PARAMETERS

ANALYSIS

ACTUAL :
Pain scale of 8

Since most kidney stones

pass out of the body it
doesnt mean that we
should aviod seeking
medical consultation from
a nephrologists most
especially in our
generation we are fond of
eating unhealthy foods
that is not essential to our
body like carbonated
drinks this has so many
sugars that only makes
the kidneys works
overtime. So to prevent
the formation of kidneys
stones we should keep
ourself hydrated by
drinking water for 34L/day and if we
experience any
excruciating pain or
dysuria we should consult
right away to a
nephrologists for early
interventions. For some of
us who are curious
enough to know the
functions of your kidneys
as early as now a simple
urinalysis will help you
find out. One of the
common cause of kidney
stones is UTI this is an
example of ascending

FORSEABLE:

Abscess formation

Serious infection of the kidney

that diminishes renal function

Urinary fistula formation

Ureteral scarring and stenosis

Ureteral perforation

Extravasation

Urosepsis

Renal loss due to long-standing

obstruction
LAB RESULTS
CBC
Hematocrit of 0.24
Hemoglobin of 75
Rbc count of 35
X-RAY

Complete staghorn calculus that fills

microscopic filter for

blood. It's possible to
lose as much as 90%
of kidney function
without experiencing
any symptoms or
problems.

the collecting system of the kidney (no

intravenous contrast material in this
patient). Although many staghorn
calculi are struvite (related to infection
with urease-splitting bacteria), the
density of this stone suggests that it
may be metabolic in origin and is likely
composed of calcium oxalate.
Percutaneous nephrostolithotomy or
perhaps even open surgical
nephrolithotomy is required to remove
this stone.
DIAGNOSTIC EXAM

abdominal X-rays.
intravenous pyelogram (IVP)
retrograde pyelogram.
ultrasound of the kidney (this is the
preferred study)
MRI of the abdomen and kidneys.
abdominal CT scan.

TREATMENT AND MANAGEMENT

Extracorporeal shock wave

lithotripsy (ESWL). This uses highenergy shock waves which are
focused on to the stones from a
machine outside the body to
break up stones. You then pass
out the tiny broken fragments

infection. If in our younger

years we were able to
know that we had a UTI
we should promptly treat
it with antibiotics and
water therapy. So I
conclude that as early as
know we should take care
of ourselves we should
drink plenty of water as
much as possible as long
as it is not
contraindicated. Because
all thing that get used to
it soon gives up and there
is nothing we can do
about. Except for organ
transplantation.

when you pass urine.

Percutaneous nephrolithotomy
(PCNL) is used for stones not
suitable for ESWL. A nephroscope
(a thin telescope-like instrument)
is passed through the skin and
into the kidney. The stone is
broken up and the fragments of
stone are removed via the
nephroscope. This procedure is
usually done under general
anaesthetic.

Ureteroscopy is another
treatment that may be used. In
this procedure, a thin telescope is
passed up into the ureter via the
urethra and bladder. Once the
stone is seen, a laser (or other
form of energy) is used to break
up the stone. This technique is
suitable for most types of stone.

Stone removal can be done by

a traditional operation where the
skin has to be cut to allow access
to the ureter and kidney. This is
only needed in a very small
number of cases where the above,
newer techniques have not
worked or are not possible. It may
be done if you have a very large
stone in your kidney.

PREVENTION
Avoid stone-forming foods: Beefs,
chocolate, spinach, rhubarb, tea, and
most nuts are rich in oxalate, and colas
are rich in phosphate, both of which
can contribute to kidney stones. If
you suffer from stones, your doctor
may advise you to avoid these foods or
to consume them in smaller amounts
PROGNOSIS
Most kidney stones pass out of the
body without any intervention by
a physician. Cases that cause lasting
symptoms or other complications may
be treated by various techniques, most
of which do not involve major surgery.