Nursing care of patients with urolithiasis involves:

a. Controlling Pain.

(1) Administer pain medications as prescribed and assess patient frequently, as this pain can be excruciating.

(2) Hot bath or moist heat to painful area.

b. Relief of Obstruction.

(1) Encourage fluids.

(2) Observe strict I & O.

(3) Assist physician in catheterization or cystoscopy, as ordered.

c. Determine Stone Type.

(1) Strain all urine.

(2) Send stones to laboratory for identification.

d. Diet Modification.

(1) Implement diet modifications as ordered.

(2) Alter the pH of the urine to reduce stone formation.

(a) To acidify urine, give citrus juices or ascorbic acid (vitamin C).

(b) To alkalinize urine, give sodium bicarbonate.

e. Prepare Patient for Surgery. Surgical intervention is indicated if the stone is causing:

(1) An obstruction that cannot be relieved.

(2) Infection that is not responsive to treatment.

(3) Unrelenting pain.

(4) Damage to the urinary system.