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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Deficient Knowledge

Nursing Diagnosis

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May be related to

  • Lack of exposure/recall; information misinterpretation
  • Unfamiliarity with information resources

Possibly evidenced by

  • Questions; request for information; statement of misconception
  • Inaccurate follow-through of instructions, development of preventable complications

Outcome Evaluation

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  • Verbalize understanding of disease process and potential complications.
  • Correlate symptoms with causative factors.
  • Verbalize understanding of therapeutic needs.
  • Initiate necessary lifestyle changes and participate in treatment regimen.
Nursing InterventionsRationale
Recall and analyze disease process and future expectations.Provides knowledge base from which patient can make informed choices.
Emphasize importance of increased fluid intake of 3–4L a day or as much as 6–8 L a day. Encourage patient to notice dry mouth and excessive diuresis and diaphoresis and to increase fluid intake whether or not feeling thirsty.Flushes renal system, decreasing opportunity for urinary stasis and stone formation. Increased fluid losses or dehydration require additional intake beyond usual daily needs.
Review dietary regimen, as individually appropriate:Diet depends on the type of stone. Understanding reason for restrictions provides opportunity for patient to make informed choices, increases cooperation with regimen, and may prevent recurrence.
  • Low-purine diet
Decreases oral intake of uric acid precursors.
  • Low-calcium diet
Reduces risk of calcium stone formation. Note: Research suggests that restricting dietary calcium is not helpful in reducing calcium-stone formation, and researchers, although not advocating high-calcium diets, are urging that calcium limitation be reexamined.
  • Low-oxalate diet
Reduces calcium oxalate stone formation.
  • Short regimen: low-calcium or phosphorus diet with aluminum carbonate gel 30–40 mL, 30 min pc or hs.
Prevents phosphatic calculi by forming an insoluble precipitate in the GI tract, reducing the load to the kidney nephron. Also effective against other forms of calcium calculi. Note: May cause constipation.
Discuss medication regimen; avoidance of OTC drugs, and reading all product or food ingredient labels.Drugs will be given to acidify or alkalize urine, depending on underlying cause of stone formation. Ingestion of products containing individually contraindicated ingredients (calcium, phosphorus) potentiates recurrence of stones.
Promote regular activity and exercise program.Inactivity contributes to stone formation through calcium shifts and urinary stasis.
Active-listen concerns about therapeutic regimen and lifestyle changes.Helps patient work through feelings and gain a sense of control over what is happening.
Identify signs and symptoms requiring medical evaluation (recurrent pain, hematuria, oliguria).With increased probability of recurrence of stones, prompt interventions may prevent serious complications.
Demonstrate proper care of incisions and catheters if present.Promotes competent self-care and independence.

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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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