A patient is a 74 years old white male presented in the emergency room with a...

A patient is a 74 years old white male presented in the emergency room with a chief c/o right flank pain radiating to the lower abdomen associated with painful, burning urination and a foul smelling urine. Patient denies fever or chills. A urinalysis was done which showed a 3+ bacteria with a positive nitrite and elevated WBC. Intravenous pyelogram showed a 6.5 mm kidney stone in the right ureter. The patient is being treated with broad spectrum intravenous antibiotic and was scheduled for lithotripsy. Formulate a nursing care plan for this patient based on the problems presented. Provide a minimum of 3 (three) nursing problems.

Solutions

Expert Solution

Nursing priorities:-

Maintain adequate renal functioning.
Prevent complication.
Provide information about disease process, prognosis and treatment needs.

Assesment:-

Assess for pain and discomfort.
Assess for any associated symptom.
Observe for sign of UTI and obstruction.
Observe urine for blood.

Nursing intervention:-

Relieving pain:-

Administer opioids analgesics.
Encourage and assist patient to take a position comfortable for him.
Assist the patient to ambulate as it helps relieving pain.
Monitor the pain closely and report immediately if it increases.

Monitoring and managing complications:-

Encourage the patient to increase fluid intake and also ask the patient to ambulate even if it pains a bit.
Begin IV fluids if patient cannot take adequate oral fluids.
Monitor the urine output closely and regularly.
Instruct the patient to report if any increase in pain occurs.

Nursing problems:-

The patient may not cooperate due to pain.
Infection may occur if not inspected properly.
Urosepsis is also a major concern.
Obstruction of urinary tract by a stone or edema.

The mentioned complication should be throughly assessed to provide a proper and effective nursing care.

Nightingale answered 1 year ago

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