PATHOPHYSIOLOGY
WILHELMO DICON III
• URINARY CALCULI MAY REMAIN WITHIN THE RENAL PARENCHYMA OR RENAL
COLLECTING SYSTEM OR BE PASSED INTO THE URETER AND BLADDER. DURING
PASSAGE, CALCULI MAY IRRITATE THE URETER AND MAY BECOME LODGED,
OBSTRUCTING URINE FLOW AND CAUSING HYDROURETER AND SOMETIMES
HYDRONEPHROSIS. COMMON AREAS OF LODGMENT INCLUDE THE FOLLOWING:
• URETEROPELVIC • DISTAL URETER • URETEROVESICAL
JUNCTION JUNCTION
• EVEN PARTIAL OBSTRUCTION CAUSES DECREASED GLOMERULAR FILTRATION,
WHICH MAY PERSIST BRIEFLY AFTER THE CALCULUS HAS PASSED. WITH
HYDRONEPHROSIS AND ELEVATED GLOMERULAR PRESSURE, RENAL BLOOD
FLOW DECLINES, FURTHER WORSENING RENAL FUNCTION. GENERALLY,
HOWEVER, IN THE ABSENCE OF INFECTION, PERMANENT RENAL DYSFUNCTION
OCCURS ONLY AFTER ABOUT 28 DAYS OF COMPLETE OBSTRUCTION.
• SECONDARY INFECTION CAN OCCUR WITH LONG-STANDING OBSTRUCTION, BUT
MOST PATIENTS WITH CALCIUM-CONTAINING CALCULI DO NOT HAVE INFECTED
URINE.
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N
Subjective: Nutrition After 3 days. Of • Auscultate bowel • Inflammation or Goal partially met.
• Patient sounds, noting irritation of the
imbalanced less nursing intestine maybe
After 3days of
verbalized of than body interventions, the absence or nursing
accompanied by
being nauseous hyperactive
requirements client will be able intestinal interventions, the
and “ naga suka sounds. hyperactivity
suka ako” related to nausea to maintain usual • Eliminate smells client gain and
,diminished water
and vomiting weight. from the absorption and maintain his usual
Objective: environment. diarrhea. weight.
• Hyperactive • Avoid foods that • Reduces gastric
stimulation and
bowel sounds. might cause or
vomiting response.
• Pale conjunctiva exacerbate • Might in crease
and mucus abdominal abdominal
membrane. cramping like cramping.
caffeinated • Provides
• V/S taken as beverages, quantitative
follows: chocolate, evidence of
changes in gastric
T: 36.6 orange juice. or intestinal
P: 98 • Measure distention.
R: 18 abdominal girth.
B/P: • Observe skin or • Hypovolemia, fluid
110/90 mucous shifts and
membrane nutritional deficits
dryness, and contribute to poor
skin turgor.
turgor.
DISCHARGE PLANNING
• DIET
• DRINK ENOUGH FLUIDS TO KEEP YOUR URINE LIGHT YELLOW IN COLOR, UNLESS YOU ARE TOLD TO LIMIT FLUIDS.
• LESS SALT, LOWER YOUR ANIMAL PROTEIN INTAKE
• MEDICATION
• FOLLOW THE TREATMENT PLAN YOUR HEALTHCARE PROVIDER PRESCRIBES.
• REST
• GET PLENTY OF REST WHILE YOU€™RE RECOVERING. TRY TO GET AT LEAST 7 TO 9 HOURS OF SLEEP EACH NIGHT.
• EXERCISES
• FOLLOW ACTIVITY RESTRICTIONS, SUCH AS NOT DRIVING OR OPERATING MACHINERY, AS RECOMMENDED BY
YOUR HEALTHCARE PROVIDER OR PHARMACIST, ESPECIALLY IF YOU ARE TAKING PAIN MEDICINES.
• SPIRITUALLY
• ENCOURAGE THE PATIENT TO PRAY FOR HIS RECOVERY
• FOLLOW UP CHECKUP
• FOLLOW YOUR PROVIDER’S INSTRUCTIONS FOR FOLLOW-UP APPOINTMENTS.
• KEEP APPOINTMENTS FOR ANY ROUTINE TESTING YOU MAY NEED.
