Nursing Care Plan for Hydronephrosis
Definition
Hydronephrosis is obstruction of urinary flow proximal to the bladder can lead to accumulation of fluid pressure in the renal pelvis and ureter can lead to intense absorption in the renal parenchyma (Sylvia, 1995).
If this happens obstruction in the ureter or bladder, back pressure will affect both kidneys but if it occurs in one of ureteral obstruction due to stones or stiffness then only one kidney is damaged.
Etiology
Pathophysiology
Whatever the cause of hydronephrosis, caused by either partial or intermittent obstruction resulted in the accumulation of urine in the kidney cup. Causing dissertation trophy and renal colic. At this time renal atrophy occurs when one kidney is undergoing a gradual deterioration of the kidneys that would otherwise be gradually enlarged (compensatory hypertrophy), resulting in impaired renal function (Smeltzer and Bare, 2002).
Clinical Manifestations
Patients may be asymptomatic if the onset is gradual. Acute obstruction may cause pain in the pelvis and hips. If an infection; dysuria, chills, fever and tenderness and pyuria will occur. Hematuria and pyuria may also exist. If both kidneys in contact with the signs and symptoms of chronic renal failure will arise, such as:
Nursing Diagnosis and Interventions for Hydronephrosis
1. Pain (acute / chronic) related to acute obstruction.
Goal: Pain is reduced until it disappears.
Outcomes:
2. Risk for infection related to hemodialysis access.
Goal: Infection does not occur.
Outcomes:
3. Activity intolerance related to anemia.
Goal: Needs unmet activity.
Outcomes:
4. Imbalanced Nutrition Less than Body Requirements related to nausea, vomiting.
Goal: Nutrition met.
Outcomes:
Definition
Hydronephrosis is obstruction of urinary flow proximal to the bladder can lead to accumulation of fluid pressure in the renal pelvis and ureter can lead to intense absorption in the renal parenchyma (Sylvia, 1995).
If this happens obstruction in the ureter or bladder, back pressure will affect both kidneys but if it occurs in one of ureteral obstruction due to stones or stiffness then only one kidney is damaged.
Etiology
- Scarring kidney / ureter.
- Stone.
- Neoplasms / Tomur.
- Prostatic hypertrophy.
- Konginetal abnormalities in the bladder neck and urethra.
- Narrowing of the urethra.
- Enlargement of the uterus in pregnancy. (Smeltzer and Bare, 2002).
Pathophysiology
Whatever the cause of hydronephrosis, caused by either partial or intermittent obstruction resulted in the accumulation of urine in the kidney cup. Causing dissertation trophy and renal colic. At this time renal atrophy occurs when one kidney is undergoing a gradual deterioration of the kidneys that would otherwise be gradually enlarged (compensatory hypertrophy), resulting in impaired renal function (Smeltzer and Bare, 2002).
Clinical Manifestations
Patients may be asymptomatic if the onset is gradual. Acute obstruction may cause pain in the pelvis and hips. If an infection; dysuria, chills, fever and tenderness and pyuria will occur. Hematuria and pyuria may also exist. If both kidneys in contact with the signs and symptoms of chronic renal failure will arise, such as:
- Hypertension (due to fluid retention and sodium).
- Congestive heart failure.
- Pericarditis (due to irritation by toxic uremi).
- Pruritis (itchy skin).
- Uremic granules (urea crystals on the skin).
- Anorexia, nausea, vomiting, hiccups.
- Decreased concentration, muscle twitching and convulsions.
- Amenorrhea, testicular atrophy.
Nursing Diagnosis and Interventions for Hydronephrosis
1. Pain (acute / chronic) related to acute obstruction.
Goal: Pain is reduced until it disappears.
Outcomes:
- The patient looks relaxed.
- The patient revealed reduced pain.
- Assess the level of pain.
- Give explanation of the cause of the pain.
- Teach relaxation and distraction.
- Collaboration of analgesic.
2. Risk for infection related to hemodialysis access.
Goal: Infection does not occur.
Outcomes:
- There are no signs of infection.
- No sepsis and pus.
- Wash hands before and after the action.
- Cover the wound with aseptic technique.
- Monitor if there is inflammation.
- Monitor vital signs.
- Collaboration antibiotics.
3. Activity intolerance related to anemia.
Goal: Needs unmet activity.
Outcomes:
- Improve mobility.
- Reported a decrease in symptoms of activity intolerance.
- Assess the individual response to activity, pain, dyspnea, vertigo. Increase activity gradually client.
- Collaboration with physiotherapists.
4. Imbalanced Nutrition Less than Body Requirements related to nausea, vomiting.
Goal: Nutrition met.
Outcomes:
- Oral intake increased.
- Body weight in the normal range.
- Explain the importance of adequate nutrition.
- Give small portions but frequently.
- Create a pleasant atmosphere.
- Encourage clients to eat with family members.
