*Vary with their size and location; develop as result of obstructed urine flow with distention, and tissue trauma caused by passage of rough edged crystalline stone.
KIDNEY: Asymptomatic, dull, aching flank pain, microscopic hematuria, manifestations of UTI
URETERAL: Renal colic- Acute flank pain on affected side; often radiates to suprapubic region, groin, and external genitals. Nausea, Vomitting, pallor, and cool clammy skin.
BLADDER: Asymptomatic; dull suprapubic pain, possibly associated with exercise or voiding; gross or microscopic hematuria; manifestations of UTI.
*Urinalysis- hematuria, WBC's, Crystal fragments, PH for type of stones.
*Chemical analysis- of the stones determine type and suggest preventiv measures for further stone formation.
*Urine, calcium, uric acid, oxalate levels- measures amount of these over 24hr period, may identify causes of lithiasis.
*Serum calcium, phosphorus, and uric acid levels-identifys factors contributing to calculus formation
* KUB- kidneys, ureters, and bladder x-ray shows calculi
* Renal ultrasonography- used reflective sound waves to detect stones and kidneys for hydronephrosis.
* Spiral computed tomography (CT)- can use contrast or not; shows calculi, ureteral obstruction, other renal d/os
*Cystoscopy- visualize and poss remove calculi
Increase fluid intake 2.5-3.0 L per day is recommended
Fluid is to produce approx 2.0-2.5L of urine a day
Calcium & Cystine- low sodium, restricted protein diet
Uric acid stones- diet low in purines ( goose, organ meats, sardines, herring, venison, mod in beef, pork, crab, chicken, salmon, and veal)
Diet may be modified to maintain a urinary pH that does not promote lithiasis.
Uric acid and cystine- foods that alkalinize urine
All types of calculi- Increase fluid intake