Hydronephrosis

Subject: Medical and Surgical Nursing I (Theory)

Overview

Hydronephrosis is the abnormal enlargement of the kidney's pelvis and calyces as a result of intermittent or partial restriction of the urine's outflow. The symptoms of this condition include lumbar pain, nausea, vomiting, discomfort at the renal angle, and cramping in the lower abdomen. Investigations used to diagnose it include X-ray KUB, intravenous urography, ultrasound, and others. Antibiotics, fluids, and rest can all be used to manage an infection. It's possible to avoid nephrostomy. If just one kidney is functioning normally and the other is diseased, a nephrectomy may be performed. After surgery, administer catheter care and timely patient ambulation in accordance with site procedures and hospital policy. Encourage deep breathing, practice coughing, and offer chest physical therapy as needed.

Hydronephrosis

Hydronephrosis is the abnormal enlargement of the kidney's pelvis and calyces as a result of intermittent or partial obstruction of the urine's outflow.

Sign and Symptoms

  • Pain in lumbar region.
  • Nausea and vomiting.
  • Renal angle tenderness.
  • Lumber abdominal spasm.
  • Colicky pain radiating to genitalia if calculus is present.

Investigation

  • X-ray KUB.
  • Intravenous urography.
  • Ultrasound.
  • Serum biochemistry to assess kidney function.
  • Urine routine examination.

Treatment

  • Remove all cause.
  • Relieve pain with antispasmodics and analgesics.
  • Treat infection with antibiotics, fluid and rest.
  • Nephrostomy may be needed.
  • Nephrectomy may be done if one kidney is working properly and the other is damaged.

Nursing Management During pre and post-operative Period

Pre-operatively

  • Explain the operative procedure, expected time period and management of pain during the operation.
  • Take written consent for operation.
  • Maintain intake output chart.
  • Keep patient NPO from the midnight.
  • Provide premedication as prescribed.
  • Part preparation.
  • Advise and encourage for bath preoperatively.
  • Give enema as per the need and hospital policy.
  • Other preparation as per general surgery.

Post-operatively

  • Receive patient in post-operative bed.
  • Assess patient's consciousness level.
  • Assess operative site for bleeding and soakage.
  • Manage pain accordingly.
  • Maintain strict record of intake and output.
  • Provide catheter care.
  • Ambulate the patient in time according to the site operation and hospital protocol.
  • Encourage for deep breathing and coughing exercise and provide chest physio as necessary.
  • Other post-operative care as per other general surgery

References

  • childrenshospital.org › Conditions + Treatments › Hydronephrosis
  • childrenshospital.org › Conditions + Treatments › Hydronephrosis
  • emedicine.medscape.com/article/436259-overview
  • healthline.com/health/unilateral-hydronephrosis
  • https://medlineplus.gov › Medical Encyclopedia
  • kidney.org/atoz/content/hydronephrosis

  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013

  • medicinenet.com › home › hydronephrosis index
Things to remember
  • Hydronephrosis is the abnormal enlargement of the kidney's pelvis and calyces as a result of intermittent or partial restriction of the urine's outflow.
  • Symptoms include colicky discomfort that may radiate to the genitalia if calculus is present.
  • Regular urine testing and serum biochemistry to determine kidney function
  • Keep up the intake-output chart.
  • Examine the surgical site for bleeding and soakage.
  • provide care for catheters
  • Encourage deep breathing, practice coughing, and offer chest physiotherapy as needed.
Questions and Answers

Hydronephrosis is the abnormal enlargement of the kidney's pelvis and calyces as a result of intermittent or partial obstruction of the urine's outflow.

Nursing Management During Pre and Post-Operative Period

Pre-Operatively

  • Describe the surgical process, the anticipated time frame, and how pain will be managed.
  • Obtain operation's written consent.
  • Keep up the intake-output chart.
  • Maintain calm NPO starting at midnight.
  • Provide prescribed pre-medication
  • Preparation in part
  • Encourage and recommend bathing before surgery
  • According to the need and hospital policy, provide enema
  • Additional preparation in line with general surgery

Post-Operativively

  • Take the patient to the recovery room.
  • Check the patient's degree of awareness Check the surgical site for bleeding and soakage
  • Adapt pain management.
  • Keep meticulous records of your intake and output
  • Provide care for catheters
  • According to site operations and hospital procedure, ambulate the patient as soon as possible.
  • Encourage deep breathing, practice coughing, and offer chest physiotherapy as needed.

Additional postoperative care in line with other general surgery

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