4 Urolithiasis (Renal Calculi) Nursing Care Plans

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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

Here are four nursing care plans (NCP) and nursing diagnosis for patients with Urolithiasis (renal calculi): 

  1. Acute Pain
  2. Impaired Urinary Elimination
  3. Risk for Deficient Fluid Volume
  4. Deficient Knowledge
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Risk for Deficient Fluid Volume

Nursing Diagnosis

Risk factors may include

  • Nausea/vomiting (generalized abdominal and pelvic nerve irritation from renal or ureteral colic)
  • Post obstructive diuresis

Desired Outcomes

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  • Maintain adequate fluid balance as evidenced by vital signs and weight within patient’s normal range, palpable
  • peripheral pulses, moist mucous membranes, good skin turgor.
Nursing InterventionsRationale
Monitor and document I&O and daily weight.Comparing actual and anticipated output may aid in evaluating presence and degree of renal stasis or impairment. Note: Impaired kidney functioning and decreased urinary output can result in higher circulating volumes with signs and symptoms of HF.
Note incidence and document characteristics and frequency of vomiting and diarrhea, as well as accompanying or precipitating events.Nausea and vomiting and diarrhea are commonly associated with renal colic because celiac ganglion serves both kidneys and stomach. Documentation may help rule out other abdominal occurrences as a cause for pain or pinpoint calculi.
Promote fluid intake to 3–4 L a day within cardiac tolerance.Maintains fluid balance for homeostasis and “washing” action that may flush the stone(s) out. Dehydration and electrolyte imbalance may occur secondary to excessive fluid loss (vomiting and diarrhea).
Monitor vital signs. Evaluate pulses, capillary refill, skin turgor, and mucous membranes.Indicators of hydration and circulating volume and need for intervention. Note: Decreased GFR stimulates production of renin, which acts to raise BP in an effort to increase renal blood flow.
Weigh daily.Rapid weight gain may be related to water retention.
Check Hb and Hct, electrolytes.Assesses hydration and effectiveness or need for interventions.
If patient can’t drink required amount of fluids, supplemental IV fluids may be given.Maintains circulating volume (if oral intake is insufficient), promoting renal function.
Encourage appropriate diet, clear liquids, bland foods as tolerated.Easily digested foods decrease GI activity and irritation and help maintain fluid and nutritional balance.
Administer medications as indicatedReduces nausea and vomiting.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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