A CASE STUDY ON URETEROLITHIASIS BY: BONZO, PASAL, PAYUMO, TITO

IV Pathophysiology

Diabetes Mellitus- it is a group of metabolic disease characterized by elevated glucose level in the blood resulting from defects in insulin secretions,
insulin actions or both.

Ureterolithiasis- Urine stone constituents obstruction in the ureters.

Legend:

PREDISPOSING DISEASE PROCESS LABORATORY RESULTS COMPLICATIONS IF NOT

FACTORS TREATED

PRECIPITATING SIGNS AND SYMPTOMS NURSING CARE PLAN

MEDICATIONS
FACTORS
 A CASE STUDY ON URETEROLITHIASIS BY: BONZO, PASAL, PAYUMO, TITO

PREDISPOSING FACTORS:
PRECIPITATING FACTORS
 Age: >40 years old
 Diet: increase intake of purine
 Family hx: Paternal side. An
rich food
increase disease associated
 Fluid intake: decrease fluid
in the presence of such
intake
factor
 Lifestyle: immobility
 DM history
 Metabolic disturbance: results
in Calcium accumulation of
Uric acid, ammonia, phosphate,
and calcium oxalate stone
deposition on proximal renal
Supersaturation ofstone tubule Nephrocalcinosis on Low back pain
forming constituents proximal tubule

Progression of stone to
Nidation of crystals of the loop of henle
foreign bodies from
supersaturated urine

Accumulation of stones
increasing in size Dysuria
 A CASE STUDY ON URETEROLITHIASIS BY: BONZO, PASAL, PAYUMO, TITO

Urinalysis: urine is Blood vessel wall surface

Hematuria
smoky red erosion
Impaired urinary
elimination related to
obstruction of renal calculi
Urinalysis: proteinuria Stone formation in the
 Ascertain previous
positive two kidneys
pattern of
elimination
 Encourage increase
of fluids
Increase size of stone in Acute pain related to Stone descends in the
 Discuss dietary
the kidneys increased force of ureteral ureters
restrictions X-ray result 3/4/11: contractions:
 Emphasizing consider distal ureteral
importance of junction calculi, right Stone matrix  Take v/s Aggregation occurs to
hygiene. progression  Provide comfort form large stones
measures like
touch & deep
Slow passage of urine Urinary calculus breathing.
Oliguria: 350  Encourage Blockage of the ureters
cc/day divertional
Abdominal spasm activities.
 Encourage rest Increase intra-ureteral
Lower abdominal periods. contraction
pain
Tramadol 50 mg. Flank pain radiating from
the thighs to the Urethral walls became
genitalia, 8/10 pain seriously stretched
scale, facial grimace (+)
 A CASE STUDY ON URETEROLITHIASIS BY: BONZO, PASAL, PAYUMO, TITO

Hyperthermia related to
increase number of Loses the ability to
pyrogens. undergo peristaltic
contraction
 Apply TSB
 Provide quiet Pcm 500 mg
environment
Bleeding og urethral
conducive for
walls
resting
 Loosen clothing
 Encourage increase Hematuria
fluid intake. Fever (38.0
degrees Celsius), Invasion of bacteria
shivering
Scarring of Urinalysis:
CBC: 3/4/11 urethral walls
Urine
Infection caused bu urea
WBC: 22,700 appears
splitting bacteria
10^3/uL smoky red
microorganism
 Ofloxacin Statsis of urine
 Meropenem
 piptazo Pyuria Increased
leukocyte
Formation of stone in
the ureter/bladder
 A CASE STUDY ON URETEROLITHIASIS BY: BONZO, PASAL, PAYUMO, TITO

Decreased
erythropoietin

CBC: 3/4/11

RBC: 2.95 10^6/uL

Anemia Decreased RBC

Renal failure

Death

Increased SNS response

r/t dysfunction of
autonomic nervous
Cardiac arrest system

Increased RAAS
Increased cardiac
workload

Increased viscosity of
blood