Need help with care plan: CKD stage II, Diabetes, Hypertension, HIV, Kidney Stones

[~Tinkerbell~]

I am a new nursing student and am having difficulty constructing a care plan for my patient. I need one long term goal and two short term goals w/ interventions. I am at a loss as to were to begin. My patient was admitted for kidney stones, UTI, and flank plain. I am having difficulty formulating and prioritizing nursing diagnosis due to his medical history which includes:

1. CKD stage II with baseline creatine of 1.2

2. Diabetes

3. Hypertension

4. Kappa restricted multiple myeloma associated with HIV

5. HIV on HAART therapy

6. History of kidney stones

I cant seem to get past this point to even start my care plan. He was scheduled to be discharged to a rehab facility the day after I saw him.

Any help and guidance you can give me would be appreciated

[idahostudent2011]

the most important short term goal is to control the pain, kidney stones are not a pleasant experence, I was going to say something about the uti and increasing the amount of fluid intake, but since he has CKF(and HTN), and his creantine is so low, he is probally on a fluid restriction...A long term goal could be with something to do with the decrease of UTI's, but him having HIV, that will decrease his immune system, can teach about what kinds of food that he can eat that will help increase the acidity of his urine, therefore decrease the likelyhood of another UTI. kidney stones...short term goal is to pass that stone and watch for an increase of hematurea and a decrease in urine output...that is definatly a difficult one since his comorbiditys are pretty intense. Good luck!