About
Presence of the stones in the kidney ( nephrolithiasis), can lead to movement of the stones into the ureters ( urethrolithiasis) or urethra causing severe pain.
Assess
Pain, flank pain, nausea, vomiting, diaphoresis, pale, frequency or urination; monitor for signs of obstruction- fever, no urine output, chills, changes in level of consciousness, vital sign changes.
Complications
Urinary obstruction; infection, surgical obstruction; kidney failure; sepsis
Diagnosis
- Acute pain related to obstruction from renal calculi
- Impaired urinary elimination related to pain, obstruction, and irritation caused by renal calculi
- Risk for infection related to stasis of urinary contents due to obstruction
Goals
- The client will identify measures to prevent future reoccurrence of kidney stones.
- The client will be free from infection.
- The client will identify s/s of infection.
- The client will report effective pain relief
Interventions
- Monitor VS, intake and outputs, pain level, and BUN/ Creatinine.
- Notify physician immediately if no urine output, increased temperature, hypotension, and/or changes in consciousness ( may indicate sepsis).
- Administer medications ( analgesics, antibiotics, etc.) as ordered.
- Strain all urine for the presence of stones, send all stones to lab for analysis.
- Encourage fluid intake of 3L per day to dilute urine and aid in passing of stone.
- Implement dietary restrictions and medication therapy as indicated.
- Prepare for surgery as indicated.
- Monitor for signs/ symptoms of complications.
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