- Acute Pain related to Urinary system obstruction and Ureter tissue trauma as evidenced by Reports of colicky pain and Complaint of sharp and severe pain on the side or back (flank), radiating to the groin and lower abdomen
- Deficient Knowledge related to Unfamiliarity with kidney stones and Inadequate participation in care planning as evidenced by Inquiries about kidney stones and management and Inaccurate follow-through of instructions
- Imbalanced Nutrition less than Body Requirements related to Poor water intake and Inadequate knowledge of nutrient requirements as evidenced by Recurrent kidney stone formation and Inappropriate dietary choices
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Expressions of pain, such as crying Unpleasant feeling Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain related to Urinary system obstruction and Ureter tissue trauma as evidenced by Reports of colicky pain and Complaint of sharp and severe pain on the side or back (flank), radiating to the groin and lower abdomen | Patient will report pain relief or a decrease in pain using a numeric pain scale. Patient will appear relaxed without facial grimacing or crying. Patient will verbalize the absence of pain and burning during urination. | 1. Promote pain relief. Kidney stones are often extremely painful, and the patient may require NSAIDs or opioid medications for relief. 2. Use OTC pain relievers. The healthcare provider may prescribe ibuprofen or naproxen sodium to treat minor pain from kidney stones in the outpatient setting. 3. Treat the underlying cause. Determine if stones are caused by infection, obstruction, diet, or another cause to treat and prevent further stone formation effectively. 4. Allow passage of the stone. Alpha-blockers or calcium channel blockers may also be prescribed to help pass a kidney stone more easily by relaxing the ureters. | Patient reported pain relief or a decrease in pain using a numeric pain scale. Patient appeared relaxed without facial grimacing or crying. Patient verbalized the absence of pain and burning during urination. |
| Subjective Data: -Verbalizes poor understanding -Seeks additional information Objective Data: -Inaccurate demonstration or teach-back of instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge related to Unfamiliarity with kidney stones and Inadequate participation in care planning as evidenced by Inquiries about kidney stones and management and Inaccurate follow-through of instructions | Patient will verbalize two strategies to prevent kidney stones. Patient will adhere to dietary recommendations to prevent kidney stones. Patient will be able to identify signs of kidney stones and when to seek treatment. | 1. Identify signs of poor hydration and increase water intake. Ensure the patient recognizes headaches, a dry mouth, an increased heart rate, and fatigue as signs of thirst and dehydration. Remind them also to assess the color of their urine. Urine should be straw-colored. If it is dark/amber-colored, the patient needs to drink more water. 2. Instruct on expectations after surgery. Remind the patient that their urine may be pink or have small clots following lithotripsy or surgery. Stone fragments will pass over the next days and weeks. If fever, chills, heavy bleeding, or an inability to urinate occur, the patient should seek medical attention. 3. Refer the patient to a dietitian. A dietician can assist the patient in creating a diet that can lower the risk of kidney stones. High oxalates- avoid this with patients at risk for calcium oxalate stones. Foods include rhubarb, spinach, soy products, beets, okra, sweet potatoes, almonds, tea, and chocolate. High sodium- calcium, and excess salt are eliminated proportionately in the urine. The more salt consumed, the more calcium there is, which can lead to new stones. Adequate calcium- calcium is necessary for healthy bones and teeth. Calcium actually binds to oxalate to remove it. Getting the right amount of calcium is recommended. High purines- can build up in the joints, resulting in gout, or travel to the kidneys, forming kidney stones. High-purine foods like alcohol, soda, sardines, mussels, scallops, bacon, and organ meats should be avoided. 4. Instruct the patient when to seek medical attention. To prevent complications, advise the patient to seek urgent medical attention when the following signs are present in a patient with kidney stones: Uncontrollable pain from the stone Severe nausea or vomiting Fever and/or chills Complete blockage of urine flow | Patient verbalized two strategies to prevent kidney stones. Patient adhered to dietary recommendations to prevent kidney stones. Patient identified signs of kidney stones and when to seek treatment. |
| Subjective Data: Verbalized that he is not aware of proper nutritional requirement and balanced diet Objective Data: -Recurrent kidney stone formation -Inappropriate dietary choices -Concentrated urine -Difficulty urinating -Haematuria -Dysuria | Imbalanced Nutrition less than Body Requirements Related to Poor water intake and Inadequate knowledge of nutrient requirements as evidenced by Recurrent kidney stone formation and Inappropriate dietary choices | Patient will not experience recurrent kidney stones. Patient will report three foods to avoid preventing kidney stone formation. | 1. Encourage increased fluid intake. Proper hydration is the most vital intervention to prevent kidney stones. Instruct patients to consume at least 2-3 L of fluid per day. 2. Encourage dietary modifications depending on the type of kidney stone. For calcium oxalate stones, instruct on reducing sodium intake and eating oxalate-rich and calcium-rich foods together. For uric acid stones, high-purine foods like organ meats, shellfish, and alcohol should be reduced. 3. Refer the patient to a dietitian for nutritional counselling. In cases of recurrent kidney stones, a carefully planned dietary regimen is necessary to ensure the patient can meet recommended nutritional requirements to prevent malnutrition while reducing stone formation. 4. Instruct on limiting or discontinuing supplements. Calcium supplements may contribute to calcium oxalate stones. Excessive vitamin C supplementation may produce more oxalate in the body. | Patient experienced recurrent kidney stones. Patient reported three foods to avoid preventing kidney stone formation. |