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):
Risk for Deficient Fluid Volume
Nursing Diagnosis
- Risk for Deficient Fluid Volume
Risk factors may include
- Nausea/vomiting (generalized abdominal and pelvic nerve irritation from renal or ureteral colic)
- Post obstructive diuresis
Desired Outcomes
- 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 Interventions | Rationale |
---|---|
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 indicated | Reduces nausea and vomiting. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- 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.
See also
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