Question

fUsing the assessment complete the nursing process with a nursing diagnosis other than and infection.

Assessment: 22-year-old women resented to the ER presented with bladder fullness, incomplete bladder emptying, and sever pain in the right flank. She rates the pain 9 on a scale of 1 to 10. She also states. That she has a history of having kidney stones. She also stated that when she is able to void it burns and has a foul odor. The patient’s vital signs are heart rate of 85, blood pressure 120/80, oxygen saturation 98% on room air, respirations are 16, humiture is 100.9. The patient takes the following medication Hydrochlorothiazide (HCTZ), 24miligrams by mouth daily detrital 2 milligrams by mouth daily, lab work shows WBC 26, urine analysis WBC to many to count, bacteria 5 + large, negative for protein and ketones, glucosepane positive,

Diagnosis:

Evaluation:

Implementation:

Planning:

Answer 1

Diagnosis: Nephrolithiasis or Renal Calculi

Evaluation:

1. Complete Blood Count- to look for any Infection by looking at Rise of TLC,DLC,ESR etc

2.Urine Microscopy and Culture- For any Urinary tract Infection by looking Pus Cells, Epithelial Cells etc.

3. Kidney Function Test- Urea and Creatinine values as they are normally Excreted by Kidney. Rise in their Values Shows Kidney Pathologies.

4. X-ray (KuB and Pelvis)- It is Done for Looking at Renal Calculus in kidney,Ureter or Bladder.

5.Ultrasound(KuB and Abdomen)- ​ It is More Sensitive Test to look at Renal Calculi in Kidney,Ureter or Bladder.

6.​​​​​.MRI/CT Scan- It is Most-Sensitive Test to Diagnose Renal Calculi.

7. Intra-Venous Pyelogram- This Test Uses Serial X-rays to See renal stone level-

At 5 Minutes - Kidney Parenchyma

At 10 Minutes - Ureter

At 15 Minutes- Bladder

Implementation-  Of Various Results by Confirmation of diagnosis by Ultrasonography or MRI/CT Scan.

And Treatment Is Done by Various Methods

a.)Conservative/Medical - Done for Stone size <6 mm

By Urinary Alkalizers And Diuretics

b.) Surgical- ESWL( Extracorporeal Shock Wave Lipthotripsy)

PCNL ( Percutaneous Nephrolithotomy)

Planning- Done to prevent The Further Calculi Formation-

• drink at least twelve glasses of water daily
• drink citrus juices, such as orange juice
• eat a calcium-rich food at each meal, at least three times a day
• limit your intake of animal protein
• eat less salt, added sugar, and products containing high fructose corn syrup
• avoid foods and drinks high in oxalates and phosphates
• avoid eating or drinking anything which dehydrates you, such as alcohol.