Ureter Obstruction/Hydronephrosis

[luv2shopp85]

How do I write a care plan on this? I have been looking through my nursing diagnosis books that I have and i can't find anything on these. Would a ureter obstruction and hydronephrosis be considered acute renal failure? I know that the patient has pain and that would be one diagnosis but im just having a really hard time with the rest. Its so hard to do a care plan for patients in the ER. I only saw this guy for 2 hours before he was transferred to another hospital. Can anyone help?

[luv2shopp85]

I just looked in my book there are 3 types of acture renal failure

prerenal-results in a decrease in renal blood flor

postrenal - caused by an obstruction

intrarenal - caused by a problem within the vasc system, glomeruli, or tubules.

So would a ureteral obstruction be considered the postrenal form of acute renal failure?

[Marie_LPN, RN, LPN, RN]

Consider the buildup of waste products that aren't being eliminated.

[Daytonite, BSN, RN]

luv2shopp85. . .the nursing care plan process always starts with the symptoms the patient was having. you use his medical diagnosis as a tool to point the way to clues you may have missed. from family practice notebook i brought up this page http://www.fpnotebook.com/ren35.htm about hydronephrosis. according to this source, did your patient have any of the following?

• abdominal pain - if so, describe and locate it
  
• groin pain
  
• a mass or lump upon examination and palpation of the flank, suprapubic area or abdomen
  
• anuria
  
• hematuria
  
• sediment or crystals in his urine
  
• pyuria
  
• what tests, if any were done in the er and what were their results?

the answers to any of those questions become the source of any abnormal symptoms the patient is experiencing. those abnormal symptoms will be the items you will be able to find in section ii (the alphabetical listing of symptoms, problems, medical diagnoses and clinical states) in your nursing diagnosis handbook that will then lead you to potential nursing diagnosis categories you might use for your care plan.

remember that we are but nurses. the doctors are going to treat the medical diagnosis. your careplan may not seem as exciting. it is probably going to address nursing measures to relieve the pain, monitor his urine output and iv fluids, attending to a risk for infection, and teaching the patient what to expect insofar as tests to be done or the course of his potential disease. that is as important to his recovery as what the doctor is ordering.