Non-Hodgkin’s lymphoma

A kidney stone described as calculi in the urinary tract bladder, the ureters and the kidneys. Incidence peaks between ages 30 and 50 years old and most common in men. Predisposing factors are immobility, hypercalcemia, urinary tract infections, urine stasis, high urine specific gravity and genetic predisposition. Calculi are well formed by deposition of crystalline substances, including calcium oxalate, calcium phosphate and uric acid. Calculi can pass through the urinary tract that can lead to infection and hydronephrosis.

Assessment findings reveal acute sharp and intermittent pain, dull, tender ache in the flank, nausea and vomiting, fever and chills, hematuria, abdominal distention, pyuria, rarely oliguria and anuria. Laboratory findings will reveal visible calculi through kidneys, ureters and bladder radiograph. Stone analysis detects mineral content of calculi. Intravenous pyelography determines size and location of calculi. Renal ultrasonography reveals obstruction changes, such as hydronephrosis.

For the management, pharmacologic therapy is needed which may include Intravenous opioid medications, prophylactic antibiotics and antiemetics. Prescriptions needed from health practitioner before a client can take this medication; because a needed schedule and when to return for follow up is set.

For pain, the client given high doses of morphine round the clock and every thirty minutes the pain is being assessed. Shock can occur because of the excruciating pain. To provide comfort measures, encourage bed rest, teach the client relaxation techniques such as deep breathing exercises. This time massage is contraindicated because of the chronic pain.

Hot baths or moist heat to the flank areas had been applied. Round the clock high fluid intake implemented to help the calculi release or dissolve. For the client who cannot pass the calculus spontaneously some non-surgical procedures are applied.

Extracorporeal shock wave lithotripsy, which is used tobreak up calculus so that the client can pass the particles during urination. Uterotoscopy involves insertion of instruments through a cystoscope to visualize and access the calculus and then remove or fragment it with laser energy or ultrasound. Stone dissolution involves infusion of chemolytic solutions through a percutaneous nephrostomy tube. This procedure is used for clients who are poor risks for other treatments.

Endourologic procedures, integrate the skills of the radiologist and urologist to extract renal calculi without major surgery. An endoscopic instrument is introduced through a percutaneous nephrostomy ; forceps or a basketlike device on the instrument that extracts the calculus.

To prevent recurrence of kidney stone lifestyle modification is implemented like the diet. Avoid foods high in calcium and purine such as shellfish, anchovies, asparagus and organ meats. Increase fluid intake to three liters per day. Physical activity like sports is all you need to prevent kidney stones. Hot environments exposure is avoided because this can cause fall in urinary volume.