- low-purine diet to reduce urinary excretion of uric acid (shellfish, mushrooms, and
organ meats), limit protein, Allopurinol.
- Avoid food contain oxylate: spinach, strawberries, chocolate, tea, peanuts, and wheat
bran
Historically, patients with calcium-based renal stones were advised to restrict calcium
in their diet. However, recent evidence has questioned the advisability of this practice,
except for patients with type II absorptive hypercalciuria (half of all patients with
calcium stones), in whom stones are clearly due to excess dietary calcium.
It is thought that a high-protein diet is associated with increased urinary excretion of
calcium and uric acid, thereby causing a supersaturation of these substances in the
urine. Similarly, a high sodium intake has been shown in some studies to increase the
amount of calcium in the urine.
Foods high in purine (shellfish, anchovies, asparagus, mushrooms, and organ meats)
are avoided
Renal Calculi/ Assessment
- History and physical exam
- Location, severity, and nature of pain
- I/O
- Vital signs, looking for fever
- Palpation of flank area, and abdomen
-? N/V - Nursing interventions
- Primary is to treat pain – usually with opioids
- Ambulate
- Force fluids, may have IV
- Watch for fluid overload
- Strain urine – send stone to lab if passed
- Accurate I/O
- Medicate N/V
Renal Calculi/Surgical removal
- Routine pre and post op care