Need help with I & R for "altered urinary elimination"

[Rachael243]

help I need 3 more Interventions & Rationale for altered urinary elimination r/t damage to renal tissue (Renal cancer) And I just cant find/think of any more. I'm struggling. Help me out

this is what I have so far:

I - Monitor urinary elimination, including consistency, odor, volume and color

R - These parameters help determine adequacy of urinary function (Weber, 2005)

I - Instruct pt. to drink a minimum of 1500 - 2000 mL of fluids per day

R - Increased fluids during the day will increase urinary output and discourage bacterial growth (Weber, 2005)

I - Appraise pt. knowledge on effects of renal tissue damage on urinary elimination

R - Assessing the clients knowledge will provide a foundation for building a teaching plan based on his present understanding of his condition (Weber, 2005).

I - Describe the rational behind management, therapy, and treatment recommendations

R - Adequate information about treatment options is important to diminish anxiety, promote compliance, and enhance decision making (Weber, 2005)

I - Cleanse perineal are and keep dry

R - Perineal care decreases risk of skin irritation, breakdown, and development of ascending infection (Weber, 2005).

I - Monitor blood urea nitrogen (BUN), creatine, white blood cell (WBC) count, and urinalysis (UA).

R - These labratoriy tests reflect renal funtion and can identify complications (Weber, 2005).

I - Assess for signs of fluid overload: dyspnea, tachycardia, crackles, distended neck veins, and peripheral edema

R - Hydration is used to counterbalance effects of calcium and protein buildup. Overhydration needs to be prevented (Gulanick & Myers, 2011).

[Jolie, BSN]

"Appraise patient knowledge..." and "Assess for signs of..." are actually assessments, not interventions. I don't know your instructor's thought processes, but one might argue that monitoring lab values falls under assessment, also.

Remember, you assess first, (the patient's physical status, psycho-social status, emotional state, knowledge level, family status, etc.), then form a plan of care that consists of interventions.

Based upon your holistic assessment of the patient, family, social situation, knowledge level, etc. are there any other areas of intervention you can think of? How about self care? How about nutritional status? Pain management? Emotional needs? Spiritual needs?

You are off to a good start.

[Rachael243]

thanks, that actually helps

:)