Priority Nursing Diagnosis for Cystolithotripsy... need help!

[lynn22]

First and foremost, cystolithotripsy is the removal of stones in the bladder; could be through crushing, destruction or removal. But, in my patient case it is removal.

Can anyone give me two priority nursing diagnosis after the surgery/ post-operative?

I'm torn between:

-Acute Pain because of the surgery. pain score: 9/10, 4 hours after the surgery.

-Risk for infection because of the surgery, too. Her WBCs are high.

Can you add more?

Or suggest what should be prioritize more?

Thanks. :)

[sunnycalifRN]

ah, yes . . . homework. those nursing diagnoses are fine. you'll learn more by doing the research on your own.

[bluemartian, BSN]

Risk for bleeding

[Guest2010]

One of the easiest ways I know of teaching nursing dx priorities: Start with your ABC's first....and that validates bluemartian's post of "risk for bleeding".

Relax, remember the ABC's and you will do fine.

[PetiteOpRN]

I'm not a urology nurse, but every cystolithotripsy I've observed has been transurethral (no incision, so no increased risk of infection or bleeding). Also, I have only ever seen them vaporize the stones with a laser, not "crush or remove" them.

Intra-operatively: If the stone is being vaporized with a laser, then the patient is at risk for burns from the laser. There a risk associated with general anesthesia, and a risks associated with being in the lithotomy position (including lower extremity nerve damage).

Then look at how and why the patient developed the stones. Most develop stones because of an inability to empty the bladder or due to recurrent UTIs. If these are contributing factors, then they should be dealt with immediately following surgery to prevent recurrence.

Hope that helps. There is also a specific forum where students can ask for help. Try posting there in with questions. There are people who are much better with nursing dx than me who frequent those forums.

[SandyB]

Risk for dx have NOT happened so they can not be number one if there is anything that is actually happening.

Pain is happening.

[misia84]

I agree with sandy...