Vesicoureteral reflux (VUR) is the abnormal backflow of urine from the bladder into the ureter and up to the kidney. The diagnosis of VUR rarely occurs after five years of age. There are two types of VUR, primary and secondary reflux. Primary reflux which is present at birth, is caused by an inadequate valvular mechanism at the ureterovesical junction. The inadequate valve in primary reflux is caused by the shortened submucosal tunnel that shortens bladder filling. Secondary reflux is associated with obstruction (50% of cases in infants are caused by posterior urethral valves) or damage to the nerves that control normal bladder emptying (neurogenic bladder).
Voiding cystourethrogram (VCUG), radionuclide cystogram (RNC), and abdominal ultrasound are done to diagnose VUR. Risk factors related with the condition include age, familial history, bladder and bowel dysfunction (BBD), urinary tract infection (UTI), and reflux.
The following effects of unrepaired reflux have been identified: urine concentration ability is inversely proportional to the grade of reflux; kidney scarring; lower-weight percentiles (in physical growth); hypertension; proteinuria; and those with bilateral scarring and an increased risk of developing end-stage renal failure. Most of the children affected, the problem will disappear on its own without surgical intervention if the infection is controlled. Management of reflux includes antibacterial therapy for infection control.
Nursing Care Plans
Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care.
May be related to
Possibly evidenced by
- Flank pain
- Bladder spasms
- Communication of pain descriptors
- Ureteral edema from surgery
- Irritability, restlessness
- Client will experience decreased pain.
|Assess verbal and nonverbal cues, type, location and severity of pain depending on age.||Provides information about pain as a basis for analgesic therapy.|
|Place client in a position of comfort; avoid unnecessary movement or manipulation of the suprapubic catheter.||Facilitates comfort and reduces bladder spasms that cause pain.|
|Demonstrate distraction techniques and provide reassurance during spasms and stay with the child when they occur to inform the child that the pain is temporary.||Decreases anxiety which tends to increase pain.|
|Maintain patency of the catheter by ensuring placement, observing flow and presence of kinks or obstruction.||Decreases pain caused by bladder distention due to catheter clogging or displacement.|
|Administer antispasmodic as prescribed.||Reduces bladder spasms caused by irritation of suprapubic catheter.|
|Administer analgesic based on pain assessment and before the pain becomes severe.||Lessens pain and promotes rest to decrease stimuli and restlessness.|
|Educate parents and child that pain will subside 24 to 48 hours following surgery and teach measures taken to control pain.||Provides knowledge about duration of pain and causes of pain.|
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