Nursing Diagnosis nursing care plans for Renal Calculi/Kidney stones determine by what we found in nursing assessment.

Nursing Assessment nursing care plans for Renal Calculi/Kidney stones

Typically, assessment findings vary depends with the size, location, and cause of the calculi:

Patient history reveals a history of pain, and determine the intensity, duration, and location of the pain. The location of the pain varies according to the placement of the stone. The pain usually begins in the flank area but later may radiate into the lower abdomen and the groin. Ask if the pain had a sudden onset. Patients may relate a recent history of hematuria, nausea, vomiting, and anorexia. In cases in which a urinary tract infection is also present, the patient may report chills and fever. Determine the patient’s history to identify risk factors

Physical Examination.

Common  symptom of renal calculi is severe pain, also referred as renal colic, which usually results from obstruction  of large, rough calculi occlude the opening to the ureteropelvic junction and increase the frequency and force of peristaltic contractions.  Pain intensity fluctuates and may be excruciating at its peak.

Patient with calculi in the renal pelvis and calyces may complain of more constant, dull pain. He may also report pain and severe abdominal pain. The patient with severe pain also typically complains of nausea, vomiting and, possibly, fever and chills. Hematuria  occur when calculi abrade a ureter, abdominal distention and, rarely, anuria

Inspection reveals a patient in intense pain who is unable to maintain a comfortable position. Assess the patient for bladder distension. Monitor the patient for signs of an infection such as fever, chills, and increased white blood cell counts. Assess the urine for hematuria. Auscultate the patient’s abdomen for normal bowel sounds. Palpate the patient’s flank area for tenderness. Percussion of the abdominal area is normal, but percussion of the costovertebral angle elicits severe pain.

Psychosocial Assessment: Patients with renal calculi may be extremely anxious because of the sudden onset of severe pain of unknown origin. Assess the  patient’s ability to cope. Since diet and lifestyle may contribute to the formation of calculi, the patient may face lifestyle changes. Assess the patient’s ability to handle such changes.

Diagnostic tests

• Kidney-ureter-bladder (KUB) radiography, and
• Excretory urography, retrograde pyelography,
• Abdominal computed tomography scan, or
• Abdominal or kidney magnetic resonance imaging
• Kidney ultrasonography.
• Urine culture of a midstream
• Evaluated A 24-hour urine

Other diagnostic test:

• Serial blood calcium and phosphorus levels indicate hyperparathyroidism and show an increased calcium level in proportion to normal serum protein levels.
• Blood protein levels are used to determine the level of free calcium unbound to protein.
• Increased blood uric acid levels may indicate gout.

Nursing diagnosis Nursing Care Plans for Renal Calculi/Kidney stones

Common nursing diagnosis found in Nursing Care Plans for Renal Calculi/Kidney stones

• Acute pain
• Altered urinary elimination
• Deficient knowledge (treatment plan)
• Impaired urinary elimination
• Ineffective tissue perfusion: Renal
• Risk for imbalanced fluid volume
• Risk for infection
• Risk for injury

Nursing Care Plans for Renal Calculi/Kidney stones

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