Nursing Implications - Renal and Urinary Tract Function

Nursing Implications

Most patients undergoing urologic testing or imaging studies are apprehensive, even those who have had these tests in the past. Pa-tients frequently feel discomfort and embarrassment about such a private and personal function as voiding. Voiding in the pres-ence of others can frequently cause guarding, a natural reflex that inhibits voiding due to situational anxiety. Because the outcomes of these studies determine the plan of care, the nurse must help the patient relax by providing as much privacy and explanation about the procedure as possible.

NURSING DIAGNOSIS

Potential nursing diagnoses for the patient undergoing assess-ment of urinary or renal function include the following:

·      Deficient knowledge about the procedures and diagnostic tests

·      Acute pain related to renal infection, edema, obstruction, or bleeding along the urinary tract, or to invasive diagnostic procedures

·       Fear related to possible diagnosis of serious illness, altered renal function, and embarrassment secondary to discussion of urinary function, and exposure and invasion of genitalia

PLANNING, IMPLEMENTATION, AND EVALUATION

The goals, nursing interventions and rationale, and expected out-comes are discussed in greater detail in the Plan of Nursing Care. Patient and family education is essential to help the patient un-derstand the purpose of the procedure and what to expect before, during, and after it. Pertinent home care considerations can be discussed at this time.

Promoting Home and Community-Based Care

TEACHING PATIENTS SELF-CARE

Many procedures and tests used to evaluate upper and lower uri-nary tract function are carried out in outpatient or short-procedure settings. Therefore, family members or other caregivers in the home may be called upon to provide postprocedural care. They need clear explanations about the procedures and tests, how to pre-pare for them, and what precautions, if any, need to be taken after-ward. The patient and family members are provided with verbal and written explanations about monitoring that may be necessary at home and are instructed about steps to take if complications occur.

CONTINUING CARE

Follow-up telephone calls made to the patient and family at home provide an opportunity for them to ask questions and to report on the patient’s status. Teaching is reinforced, and the patient is reminded of the importance of keeping follow-up appointments with primary health care providers