LESSON PLAN

ON
RENAL CALCULI

BY
Mrs. Priyadarshini,

Assistant Professor,
Dept.:- Medical Surgical Nursing,
NRI College of Nursing,
Chinakakani.
 TEACHER PROFILE
NAME OF THE TEACHER : Mrs. N. Priyadarshini

COURSE : M.Sc Nursing II year

SUBJECT : Medical Surgical Nursing - II

UNIT : VII - Glomueral Disorders and Nursing Management

TOPIC : Renal Calculi

METHOD OF TEACHING : Lecture Method

GROUP : M.Sc Nursing II year

DATE :

TIME : 1 hour

VENUE : M.Sc Nursing II year classroom

AUDIO-VISUAL AIDS : OHP, blackboard.

 OBJECTIVES

GENERAL OBJECTIVES:

At the end of the teaching class, the students will be able to gain complete knowledge regarding “Renal
Calculi” and practice in their clinical area.

SPECIFIC OBJECTIVES:

The students will be able to:

 Introduce the topic.

 Define Renal Calculi.
 Describe the etiology and risk factors.
 Enlist the types of Renal Calculi.
 Explain the pathophysiology.
 Describe the clinical manifestations.
 Enlist the diagnostic evaluation.
 Explain medical management.
 Describe surgical management.
 Explain nursing management.
S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
1. 3mins Introduce the INTRODUCTION Teacher Student takes What do you
topic A kidney stone is a hard solid mass of teaches using down notes understand by renal
the OHP from the OHP calculi?
material that forms in the kidney from the
substances in the urine.  Kidney stones or
calculi develop as a result of various
metabolic disorders which affect the fate of
calcium and other mineral elements in the
body.  Stones may be formed in the kidney,
urinary bladder, ureter and urethra.
DEFINITION
2 mins Define Renal Teacher Student takes Define Renal
2.
A kidney stone, also known as a renal teaches using down notes Calculi.
Calculi
calculus or nephrolith, is a solid piece of the OHP from the OHP
material which Is formed in the kidneys from
minerals in urine.

3. Describe etiology ETIOLOGY

5 Mins
Unknown
S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

RISK FACTORS Teacher Students What are the risk

teaches with listens and factors of Renal
Imbalance of pH in urine the help of takes down Calculi?
OHP the notes from
Alkalic: - Calcium stone
OHP
Acidic:- Uric & cristine stone
Gout
Hyperparathyroidism.
Immobility
Sedentary life style
Dehydration
Metabolic disturbances
History of renal calculi.
High mineral content in drinking water
Dietary intake
UTI
Prolonged Indwelling Catheterization
S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
4. 5mins Enlist the types TYPES Teacher Students take What are the types
of renal calculi. teaches with down the of Renal Calculi?
There are mainly 5 types:- the help of notes from
1. Calcium oxalate stone (Is the most blackboard. blackboard.

common 80% )
2. Calcium phosphate stone
3. Struvite stone (Triple stone)
4. Uric acid stone
5. Cystic stone

5. 9mins Explain PATHOPHYSIOLOGY Teacher Students listen What is meant by

pathophysiolog teaches with and take down crystal nucleation?
y Urine saturation the help of the notes from
blackboard. the
blackboard.
Super saturation

Crystal nucleation
S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION
 OBJECTIVE ACTIVITY ACTIVITY

Aggregation

Retention and growth

6. 10min Describe CLINICAL MANIFESTATIONS Teacher Students listen List out any four
Clinical teaches with and takes symptoms of Renal
Manifestation.  Severe pain in the side and back, the help of down the Calculi.
below the ribs OHP. notes from the
OHP.
 Pain that spreads to the lower
abdomen and groin
 Pain that comes in waves and
fluctuates in intensity
 Pain on urination
 Cloudy or foul-smelling urine
 Nausea and vomiting
 Fever and chills if an infection is
present.
S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION
 OBJECTIVE ACTIVITY ACTIVITY

 Urinating small amounts of urine

obstacle inhibiting their access to it.

7. 6 mins Enlist the DIAGNOSTIC EVALUATION Teacher Students What are the
Diagnostic teaches with listens and nursing
Evaluation  Blood the help of take down the responsibilities for
OHP. notes. intravenous
 Urine-analysis
pyelogram?
 Cystoscopy
 X-ray
 CT scan
 MRI
 Intravenous urogram (IVU) or
intravenous pyelogram.
 USG
 KUB.

S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION

 OBJECTIVE ACTIVITY ACTIVITY

8. 5 mins Explain MEDICAL MANAGEMENT Teacher teach Students take Why spasmodics
Medical the class using down the are used for Renal
Management  Analgesics blackboard. notes with the Calculi?
help of
 Spasmodic e.g. Buscopan blackboard.
 NSAIDs e.g. Steroid
 Maintain I/O charting
 Provide rest Teacher
9. 7 mins Explain SURGICAL MANAGEMENT teaches the Students take What is meant by
Surgical class using down the Lithotripsy?
Management blackboard. notes with the
Close procedure:- help of
blackboard.
 Lithotripsy (Extracorporeal
Shockwave lithotripsy (ESWL)-
 Noninvasive
 Percutaneous Nephrolithotomy

S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION

 OBJECTIVE ACTIVITY ACTIVITY

10. 8 mins Explain Nurisng NURSING MANAGEMENT Teacher Students What are the
Management teaches the participate in nursing
- History Collection class with the discussion and interventions to
- Physical Examination help of OHP take down the relieve pain?
notes
Nursing Diagnosis

1. Acute pain related to irritation and

spasm from stone movement in the
urinary tract as manifested by
complaints of pain, facial grimacing,
restlessness.
2. Anxiety related to uncertain outcome
and lack of knowledge regarding
possible surgery as manifested by
expressions.

S.NO. TIME SPECIFIC CONTENT TEACHER LEARNER EVALUATION

 OBJECTIVE ACTIVITY ACTIVITY

3. Impaired urinary elimination related to

trauma or blockage of ureters or
urethra as manifested by decreased
urinary output and bloody urine.
4. Risk for infection related to
introduction of bacteria following
manipulations of the urinary tract and
obstructed urinary blood flow.
5. Acute pain r/t obstructing urinary
Calculus.
6. Altered urinary elimination related To
presence of urinary calculi
7. Risk for infection r/t obstructing
Urinary calculus.
8. Altered renal peripheral tissue
Perfusion r/t post renal Obstruction.
CONCLUSION
 Renal 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. Prevention includes dietary modification
and medication with the goal of reducing excretory load on the kidneys.

SUMMARY
 Introduced the topic.
 Defined Renal Calculi.
 Described the etiology and risk factors.
 Enlisted the types of Renal Calculi.
 Explained the pathophysiology.
 Described the clinical manifestations.
 Enlisted the diagnostic evaluation.
 Explained medical management.
 Described surgical management.
 Explained nursing management.

BIBLIOGRAPHY
1) Brunner and Suddarth's text book of medical –surgical nursing twelfth edition. Page no. 1295.
2) Lewis’s medical –surgical nursing, assessment and management of clinical problems , second edition . Page no. 1131.