Teaching Plan

Learning Needs:
The patients/community folks verbalized that they want to know about facts about kidney stones/ renal
calculi like its definition, causes, signs and symptoms, and prevention since kidney stones/renal calculi is
common in their community.

Learning Diagnosis:
Knowledge deficit related to lack of information and exposure regarding renal calculi/ kidney stones

Goal:
The community folks will be able to demonstrate understanding about the disease process involved which is a
renal calculi/kidney stone

Objectives:
1. After 60 to 75 minutes of teaching session, the patient will be able to define in his own understanding about
the definition of renal calculi/kidney stones
2. After 60 to 75 minutes of teaching session, the patient will be able to enumerate causes of renal calculi
3. After 60 to 75 minutes of teaching session, the patient will be able to enumerate manifestations of renal
calculi
4. After 60 to 75 minutes of teaching session, the patient will be able to define the importance of urinalysis
5. After 60 to 75 minutes of teaching session, the patient will be able to enumerate ways of preventing renal
calculi

Purpose:
To provide the learners with the basic and adequate information regarding renal calculi/kidney stones

Learning Content Time Frame Methodology and

Strategy
1. Definition of renal calculi- Renal calculi or 10 minutes  Interactive Discussion
nephrolithiasis (commonly called kidney stones) may  Question and Answer
form anywhere in the urinary tract but usually
develop in the renal pelvis or the calyces of the Resources:
kidneys. Calculi formation follows precipitation of  Visual Aide
substances normally dissolved in the urine, such as  Willingness,
calcium oxalate, calcium phosphate, magnesium cooperation and time
ammonium phosphate or, occasionally, urate or of patient
cystine. Renal calculi vary in size and may be solitary
or multiple. They may remain in the renal pelvis or
enter the ureter and may damage renal parenchyma;
large calculi cause pressure necrosis. In certain
locations, calculi cause obstruction, with resultant
hydronephrosis, and tend to recur.
2. Causes of renal calculi- 20 minutes  Interactive Discussion
 Question and Answer
❑ Dehydration: Decreased urine production
concentrates calculus-forming substances Resources:
 Visual Aide
❑ Infection: Infected, damaged tissue serves as a site  Willingness,
for calculus development; pH changes provide a cooperation and time
favorable medium for calculus formation (especially of patient
for magnesium ammonium phosphate or calcium
phosphate calculi); or infected calculi (usually
magnesium ammonium phosphate or staghorn
calculi) may develop if bacteria serve as the nucleus
in calculus formation. Infections may promote
destruction of renal parenchyma.

❑ Obstruction: Urinary stasis (as in immobility from

spinal cord injury) allows calculus constituents to
collect and adhere, forming calculi. Obstruction also
promotes infection, which, in turn, compounds the
obstruction.

❑ Metabolic factors: These factors may predispose to

renal calculi: hyperparathyroidism, renal tubular
acidosis, elevated uric acid (usually with gout),
defective metabolism of oxalate, genetic defect in
metabolism of cystine, and excessive intake of
vitamin D or dietary calcium.
3. Manifestations of renal calculi 5 minutes  Interactive Discussion
The pain is usually of sudden onset, very severe and  Question and Answer
colicky (intermittent), not improved by changes in
position, radiating from the back, down the flank, and Resources:
into the groin. Nausea and vomiting are common.  Visual Aide
 Willingness,
cooperation and time
of patient

4. Types of Renal Calculi 3 minutes  Interactive Discussion

 Calcium calculi  Question and Answer
 Calcium Oxalate calculi
 Uric acid calculi Resources:
 Cystine calculi  Visual Aide
 Staghorn calculi  Willingness,
cooperation and time
of patient

5. Importance of Urinalysis 5 minutes  Interactive Discussion

Urinalysis may be normal, or may show increased  Question and Answer
specific gravity and acid or alkaline pH suitable for
different types of stone formation. Other urinalysis Resources:
findings include hematuria (gross or microscopic),  Visual Aide
crystals (urate, calcium, or cystine), casts, and pyuria  Willingness,
cooperation and time
with or without bacteria and white blood cells.
of patient

7. Prevention 5 minutes  Interactive Discussion

 Rather than having to undergo treatment, it is  Question and Answer
best to avoid kidney stones in the first place
when possible. It can be especially helpful to Resources:
drink more water, since low fluid intake and  Visual Aide
dehydration are major risk factors for kidney  Willingness,
stone formation. cooperation and time
  Decrease salt intake of patient
 Avoid taking medications that are not
prescribed/avoid over dosage
References: http://www.medterms.com/script/main/art.asp?articlekey=6712
http://www.wrongdiagnosis.com/f/flotch_syndrome/book-diseases-7a.htm
http://www.medicinenet.com/kidney_stone/page4.htm