Urolithiasis is the process of forming stones in the kidney, bladder, and/or urethra (urinary tract). Kidney stones (calculi) are formed of mineral deposits, most commonly calcium oxalate and calcium phosphate; however, uric acid, struvite, and cystine are also calculus formers. Although renal calculi can form anywhere in the urinary tract, they are most commonly found in the renal pelvis and calyces. Renal calculi can remain asymptomatic until passed into a ureter and/or urine flow is obstructed, when the potential for renal damage is acute.
There are four main types of kidney stones — calcium stones, uric acid stones, struvite stones and cystine stones.
Nursing Care Plans
Impaired Urinary Elimination
May be related to
- Stimulation of the bladder by calculi, renal or ureteral irritation
- Mechanical obstruction, inflammation
Possibly evidenced by
- Urgency and frequency; oliguria (retention)
- Void in normal amounts and usual pattern.
- Experience no signs of obstruction.
|Record I&O and characteristics of urine.||Provides information about kidney function and presence of complications (infection and hemorrhage). Bleeding may indicate increased obstruction or irritation of ureter. Note: Hemorrhage due to ureteral ulceration is rare.|
|Determine patient’s normal voiding pattern and note variations.||Calculi may cause nerve excitability, which causes sensations of urgent need to void. Usually frequency and urgency increase as calculus nears ureterovesical junction.|
|Encourage the patient to walk if possible.||To facilitate spontaneous passage.|
|Promote sufficient intake of fluids.||Increased hydration flushes bacteria, blood, and debris and may facilitate stone passage.|
|Offer fruit juices ,particularly cranberry juice.||To help acidify urine.|
|Strain all urine. Document any stones expelled and send to laboratory for analysis.||Retrieval of calculi allows identification of type of stone and influences choice of therapy.|
|Investigate reports of bladder fullness; palpate for suprapubic distension. Note decreased urine output, presence of periorbital and dependent edema.||Urinary retention may develop, causing tissue distension (bladder, kidney), and potentiates risk of infection, renal failure.|
|Observe for changes in mental status, behavior, or level of consciousness.||Accumulation of uremic wastes and electrolyte imbalances can be toxic to the CNS.|
|Maintain patency of indwelling catheters (urethral, urethral, or nephrostomy) when used.||May be required to facilitate urine flow and prevent retention and corresponding complications. Note: Tubes may be occluded by stone fragments.|
|Irrigate with acid or alkaline solutions as indicated.||Changing urine pH may help dissolve stones and prevent further stone formation.|
|Check laboratory studies (electrolytes, BUN, Cr).||Elevated BUN, Cr, and certain electrolytes indicate presence and degree of kidney dysfunction.|
|Obtain urine for culture and sensitivities.||Determines presence of UTI, which may be causing or complicating symptoms|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans and nursing diagnoses related to reproductive and urinary system disorders:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Renal Failure | 6 Care Plans
- Benign Prostatic Hyperplasia (BPH) | 5 Care Plans
- Chronic Renal Failure | 11 Care Plans
- Hemodialysis | 3 Care Plans
- Hysterectomy (TAHBSO) | 6 Care Plans
- Mastectomy | 14+ Care Plans
- Menopause | 6 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Peritoneal Dialysis | 6 Care Plans
- Prostatectomy | 6 Care Plans
- Urolithiasis (Renal Calculi) | 4 Care Plans
- Urinary Tract Infection | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans