Nursing Care Plan (NCP) for Renal Calculi

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Outline

Lesson Objectives for Renal Calculi

  • Define Renal Calculi:
    • Understand the definition and nature of renal calculi, commonly known as kidney stones, as solid deposits formed in the kidneys from minerals and salts.
  • Recognize Types and Composition:
    • Identify the different types of renal calculi based on their composition, including calcium oxalate, calcium phosphate, uric acid, and struvite stones.
  • Understand Etiology and Risk Factors:
    • Comprehend the etiology of renal calculi, considering factors such as dehydration, dietary habits, metabolic disorders, and genetic predisposition.
  • Learn Clinical Manifestations:
    • Familiarize oneself with the clinical manifestations of renal calculi, including severe flank pain, hematuria, and urinary tract symptoms.
  • Explore Preventive Measures and Management:
    • Understand preventive measures, such as adequate hydration and dietary modifications, to reduce the risk of renal calculi formation.
    • Learn about the management strategies for renal calculi, including pain management and interventions to facilitate stone passage or removal.

Pathophysiology of Renal Calculi

  • Formation in the Kidneys:
    • Renal calculi, or kidney stones, form when certain substances in the urine, such as calcium, oxalate, and uric acid, become highly concentrated and crystallize in the kidneys.
  • Crystal Aggregation:
    • Crystals aggregate and combine to form small, solid masses within the renal pelvis or calyces of the kidneys, known as renal calculi.
  • Obstruction and Stasis:
    • As renal calculi grow in size, they may obstruct the urinary tract, causing a blockage that leads to urinary stasis.
    • Urinary stasis contributes to further crystal formation and stone growth.
  • Inflammatory Response:
    • Obstruction and irritation of the urinary tract trigger an inflammatory response, leading to symptoms such as pain, hematuria, and urinary urgency.
  • Stone Passage or Retention:
    • Renal calculi may either pass through the urinary tract spontaneously or become lodged at various points, causing persistent symptoms and potential complications such as hydronephrosis.

Etiology of Renal Calculi

  • Dehydration:
    • Inadequate fluid intake can lead to concentrated urine, increasing the risk of crystal formation and stone development.
  • Dietary Factors:
    • High intake of certain substances, such as oxalate-rich foods (e.g., beets, nuts, chocolate) or purine-rich foods (e.g., organ meats), can contribute to stone formation.
  • Metabolic Disorders:
    • Conditions like hypercalciuria, hyperoxaluria, and hyperuricosuria can result in an excess of calcium, oxalate, and uric acid in the urine, respectively, promoting stone formation.
  • Genetic Predisposition:
    • Genetic factors may influence an individual’s susceptibility to developing renal calculi, including familial tendencies for certain metabolic disorders.
  • Urinary Tract Anomalies:
    • Structural abnormalities in the urinary tract, such as congenital malformations or obstructions, can create conditions favoring stone formation.

Desired Outcome in the Management of Renal Calculi

  • Pain Relief:
    • Alleviate severe pain associated with renal calculi, promoting the individual’s comfort and well-being.
    • Utilize pharmacological and non-pharmacological interventions for effective pain management.
  • Passage or Removal of Calculi:
    • Facilitate the spontaneous passage or prompt removal of renal calculi to relieve urinary obstruction and associated symptoms.
    • Implement interventions to enhance stone passage, such as hydration and positioning.
  • Resolution of Hematuria:
    • Resolve hematuria (blood in urine) associated with renal calculi, indicating the reduction of irritation and inflammation in the urinary tract.
    • Monitor urine color and clarity as indicators of hematuria resolution.
  • Prevention of Recurrence:
    • Implement preventive measures to reduce the risk of recurrent renal calculi formation.
    • Educate the individual on lifestyle modifications, dietary changes, and ongoing self-management.
  • Improved Hydration:
    • Increase and maintain adequate hydration levels to prevent concentrated urine and promote overall kidney health.
    • Monitor fluid intake and provide education on the importance of hydration.

Renal Calculi Nursing Care Plan

 

Subjective Data:

  • Severe pain of back and side
  • Radiating pain to lower abdomen and groin
  • Nausea
  • Dysuria
  • Urinary urgency
  • Urinary frequency

Objective Data:

  • Hematuria
  • Cloudy / foul-smelling urine
  • Fever (with infection)

Nursing Assessment for Renal Calculi

 

  • Pain Assessment:
    • Conduct a thorough pain assessment, focusing on the location, intensity, and characteristics of flank pain associated with renal calculi.
    • Utilize pain scales and monitor changes over time.
  • Urinary Assessment:
    • Assess urinary patterns and characteristics, including frequency, urgency, and hematuria.
    • Monitor for signs of urinary obstruction or infection.
  • Stone Characteristics:
    • If calculi are passed, assess the size, color, and composition of the stones.
    • Collaborate with healthcare providers for stone analysis to guide preventive measures.
  • Fluid Intake:
    • Evaluate the individual’s fluid intake patterns and identify barriers to adequate hydration.
    • Provide education on the importance of maintaining hydration to prevent stone recurrence.
  • Pain Management History:
    • Obtain a history of pain management interventions, including medications and their effectiveness.
    • Adjust pain management strategies based on the individual’s response.
  • Straining Urine:
    • Instruct the individual on the importance of straining urine to collect and analyze stones.
    • Provide appropriate education on straining techniques.
  • Hydration Education:
    • Educate the individual on the significance of ongoing hydration for kidney health and prevention of stone formation.
    • Provide practical tips to increase daily fluid intake.
  • Psychosocial Assessment:
    • Assess the individual’s psychosocial well-being, considering the impact of renal calculi on daily life and emotional well-being.
    • Provide support and resources for coping with the challenges of managing renal calculi.

 

Implementation for Renal Calculi

 

  • Pain Management:
    • Administer analgesics as prescribed to manage severe pain associated with renal calculi.
    • Encourage the use of heat therapy or other comfort measures to alleviate pain and muscle spasms.
  • Hydration Promotion:
    • Encourage and educate the individual on the importance of maintaining adequate hydration to promote urine flow and prevent stone formation.
    • Monitor fluid intake and output and provide intravenous fluids if necessary.
  • Straining Urine:
    • Instruct the individual to strain urine to collect and analyze stones for composition.
    • Provide appropriate education on the straining process and provide strainers.
  • Positioning and Ambulation:
    • Encourage changes in position, such as walking or changing positions in bed, to facilitate the movement of renal calculi.
    • Promote ambulation to enhance gravity-assisted stone passage.
  • Patient Education:
    • Provide comprehensive education on renal calculi, including preventive measures, dietary modifications, and the importance of follow-up care.
    • Offer resources and support for ongoing self-management.

Nursing Interventions and Rationales

 

  • Assess for and manage pain
    • Administer medications for pain relief, may include opioids
    • Assist in positioning patient for comfort
    • Assist with ambulation for pain relief

 

The primary symptom of renal stones is excruciating pain. Monitor for location and character of pain to determine if stone is moving. Nausea and vomiting may occur due to intense pain.

 

  • Assess for signs/symptoms of infection
    • Fever / chills
    • Oliguria
    • Hematuria
    • Administer antibiotics as necessary

 

Monitor for signs and symptoms of infection such as malodorous urine, fever and chills. Hematuria may be  a sign of infection or movement of a renal calculi.

 

  • Monitor for dehydration
    • Dry mucous membranes
    • Skin turgor / tenting

 

Nausea and vomiting as well as high levels of pain may prevent the patient from eating or drinking.

 

  • Encourage intake of fluids

 

Encourage oral fluids and initiate IV fluids if necessary. Optimal hydration may help the movement of the stone and prevent further complications..

 

  • Monitor urine output for evidence of stones

 

Provide urinary basin (hat) for toilet to measure urinary output. Inspect urine and any blood clots for possible stones.

 

  • Monitor diagnostic tests
    • Labs
      • Serum
      • Urinalysis
      • Urine Culture
    • Radiology (KUB, CT, Ultrasound)

 

  • BUN/Cr will be elevated in serum, but decreased in urine levels due to the kidneys impaired ability to filter waste
  • Urine– may be dark yellow or brown and bloody. Urinalysis will help determine if infection is present and the overall health of the kidneys.
  • Hgb/Hct (CBC) may be abnormal if dehydration is an issue
  • KUB x-rays, ultrasound and CT can show the presence of and location of calculi as well as other masses or abnormalities.

 

  • Prepare patient for and assist with procedures for removing or managing renal stones
    • Extracorporeal shock wave lithotripsy (ESWL)
    • Percutaneous nephrolithotomy
    • Ureteroscopy

 

Depending on the size and location of the stone, surgical intervention may be necessary.

  • ESWL- is strong sound waves that are used to break the stone into smaller pieces under anesthesia or sedation.
  • Nephrolithotomy- Patient will require general anesthesia for an incision made in the back to remove large stones and place stents
  • Ureteroscopy- Done under general or local anesthesia using a scope through the ureters and bladder to find and break the stones.

 

  • Provide nutrition education depending on type of calculi:
    • Calcium stones
    • Uric stones
    • Cystine stones
    • Oxalate stones

 

  • Calcium stones:  Reduce dietary protein and sodium intake, increase fluid intake
  • Uric stones:  Low purine diet (organ meats such as liver), limited protein
  • Cystine stones:  Low protein diet and increase fluids
  • Oxalate stones:  Increase fluid intake to dilute urine, reduce intake of oxalate (found in strawberries, spinach, chocolate, tea, peanuts and wheat bran)

Evaluation

 

  • Pain Relief:
    • Evaluate the effectiveness of pain management interventions in providing relief and improving the individual’s comfort level.
    • Assess changes in pain intensity, duration, and frequency.
  • Improved Urinary Elimination:
    • Monitor for improvements in urinary patterns, including increased urine flow and resolution of urinary symptoms.
    • Assess for signs of urinary obstruction resolution.
  • Stone Analysis:
    • Evaluate the results of stone analysis to determine the composition of renal calculi.
    • Use findings to guide preventive measures and management strategies.
  • Hydration Status:
    • Assess the individual’s hydration status and monitor for improvements in fluid intake.
    • Ensure the individual understands and implements ongoing hydration practices.
  • Patient Understanding:
    • Assess the individual’s understanding of preventive measures, dietary modifications, and the importance of follow-up care.
    • Provide additional education or clarification as needed.


References

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Transcript

Hey guys, in this care plan, we are going to discuss the basics of providing care to a patient who has a renal calculi. Specifically what we’re going to look at is a description of this diagnosis. We’re going to look at subjective and objective data, and then your nursing interventions with rationales. 

 

Renal calculi are more commonly known as kidney stones and these kidney stones actually form when crystallized minerals like calcium or uric acid get built up and stick together in the urinary tract. So, when this happens, this can cause a problem and create a blockage in the urinary tract. Sometimes, if they’re small enough, these stones may pass through the urinary tract, or again, if they’re large, they may get stuck and require surgical intervention. There are some important risk factors to be aware of for developing kidney stones.

 

So the major one is going to be dehydration, but you also want to think about things like infection, diet, and sometimes, they’re just hereditary. Your desired outcomes for patients who have kidney stones are number one, to try and promote normal voiding of urine, and what we mean by normal, is really that they experienced as little pain as possible. Then, we really need them to pass that kidney stone without experiencing traumatic injury. 

 

Let’s take a look at the care plan. Your subjective data for renal calculi are first and foremost, severe pain of back and side. You may hear this called blink pain, and then you may also have patients that complain of pain that radiates from the lower abdomen into the groin. Nausea is common as well as pain with urination, urinary frequency and urinary urgency. 

 

Your objective data here are hematuria, so, if you notice that there are any red blood cells in the urine, cloudy/ foul smelling urine and fever, if they have an infection. So, like we said, kidney stones can cause severe, severe pain. It’s very important that we go ahead and get a baseline pain assessment so that we can monitor the effectiveness of our treatment. To help us do that, we need to assess pain, and then go along with our interventions to relieve that. Now, the top ways that we can help relieve pain are first and foremost, to help with positioning. Get the patient in positions that are comfortable. We need to then assist them with ambulation and offer any medications that may be helpful. Now, one additional thing about pain that’s really, really important is to pay attention to the location of the pain and the character of the pain. This can sometimes help us know if the stone is moving. Now, when the pain is really severe, it’s not uncommon for patients to also experience nausea and vomiting, so we may need to treat that as well. Next in your assessment, you want to be looking for signs and symptoms of infection. We’re assessing the patient and looking for things like malodorous urine, fever, chills, and hematuria. Next we need to be monitoring for dehydration. Remember, that dehydration is one of our risk factors for developing renal calculi. It can make things a lot more complicated, so we need to assess the patient’s hydration status, and make sure that we’re paying attention to things like their nausea and their vomiting, because that could make things worse as well. 

 

Next, if we know that dehydration is a problem, we want to hydrate the patient by encouraging intake of fluids. It’s going to help with some of their symptoms and it’s also going to possibly help move that stone along, so it’s very, very important that we make sure the patient’s getting plenty of fluids. Now, as we are increasing the patient’s fluid intake, hopefully the patient’s going to be going to the toilet a lot more frequently, and hopefully moving that stone along their urinary tract and out of the body. It’s really important that during this process, we monitor the urine output very, very closely, first to see how much they’re having, and then secondly, we’re going to be looking for evidence of stones in the urine. This means that every time the patient voids, we need to be in there assessing that to see if there is any evidence that stones have been passed. The patient’s going to need a urinary hat in the toilet with something in there that’s going to catch those stones, so that we can assess and see if that’s happening. 

 

In some cases, diagnostic tests may need to be done to help us monitor kidney function and to assess the location of the stone. The common tests that you’re going to see are potentially serum BUN and creatinine, urinalysis, hemoglobin, hematocrit and CBC, KUB x-rays, which is just look at the abdomen, an ultrasound and possibly even a CT scan. Now there’s a lot you could look into, but the main thing to be aware of with these diagnostic tests is to just know that with your BUN and creatinine, you’re going to see those levels elevated in the serum, and they’re going to be decreased in the urine. 

 

Now, if the patient isn’t able to pass the stone on their own with their increased hydration, they may actually need to have surgery or a procedure of some kind to remove them, so we definitely need to prepare them for this possibility. Your common procedures for this are an ESWL, which stands for extra corporeal shockwave lithotripsy, and then you might have enough nephrolithotomy or a ureteroscopy, so those are three things that you may see. The ESWL sends shockwaves through the kidneys to break up the stones, and then the other two procedures are actually surgical to go in and remove them. The thing with this procedure here is that the patient’s still going to have to pass those stones that have been broken up, whereas with the two surgical procedures, they’re going to go ahead and remove them. 

 

Once we get those stones out and the patient’s not having those problems anymore, it’s important to educate them on their diet to help prevent the future development of stones. We’re going to provide some nutritional education, and the types of foods they need to avoid may vary based on the type of stone that they have.You can get calcium stones, Uric stones, Cystine stones, or oxalate stones, but the main dietary items that come into play with the stones are having too much protein, too much sodium, too many purines in the diet and too much oxalate in the diet, so you want to think about educating them on those different elements. Foods that are high in oxalate are things like strawberries, spinach, chocolate, tea, peanuts. Things that are high in purines are organ meats, which is probably the most common one. Those are the kinds of things you want to make sure that patients are aware of. 

 

Okay guys, that’s it for our care plan on renal calculi. Remember, we love you guys. Now, go out and be your very, very best self today and as always, happy nursing!

 

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Concepts Covered:

  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Hematologic Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
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  • Renal Disorders
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  • Lower GI Disorders
  • Urinary Disorders
  • Liver & Gallbladder Disorders
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  • Circulatory System
  • EENT Disorders
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  • Postoperative Nursing
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  • Integumentary Important Points
  • Disorders of the Thyroid & Parathyroid Glands
  • Microbiology
  • Tissues and Glands
  • Disorders of Thermoregulation
  • Urinary System
  • Emergency Care of the Neurological Patient
  • Central Nervous System Disorders – Spinal Cord
  • Renal and Urinary Disorders
  • Nervous System
  • Respiratory Disorders
  • Respiratory System
  • Neurologic and Cognitive Disorders
  • Integumentary Disorders
  • Infectious Disease Disorders
  • Perioperative Nursing Roles
  • Shock
  • EENT Disorders

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Hemodialysis (Renal Dialysis)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Heparin (Hep-Lock) Nursing Considerations
Hepatitis B Virus (HBV) Lab Values
Hiatal Hernia
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
Histamine 1 Receptor Blockers
Histamine 2 Receptor Blockers
HMG-CoA Reductase Inhibitors (Statins)
Hydralazine
Hygiene
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension (HTN) Concept Map
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertensive Crisis Case Study (45 min)
Hyperthermia (Thermoregulation)
Hyperthyroidism Case Study (75 min)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
Hypothermia (Thermoregulation)
Hypotonic Solutions (IV solutions)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
ICU Nurse Report to OR (Operating)Team
Immunology Module Intro
Impulse Transmission
Inflammatory Bowel Disease Case Study (45 min)
Informed Consent
Inserting a Foley (Urinary Catheter) – Male
Inserting an NG (Nasogastric) Tube
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Integumentary (Skin) Course Introduction
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
Interventional Radiology
Interventions for Aphasia Nursing Mnemonic (PROP)
Intracranial Pressure ICP
Intraoperative (Intraop) Complications
Intraoperative Nursing Priorities
Intraoperative Positioning
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intro to Health Assessment
Introduction to Health Assessment
Intubation in the OR
Iodine Nursing Considerations
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Isoniazid (Niazid) Nursing Considerations
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Kidney Cancer
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levofloxacin (Levaquin) Nursing Considerations
Levothyroxine (Synthroid)
Lidocaine (Xylocaine) Nursing Considerations
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Linen Change
Lipase Lab Values
Lisinopril (Prinivil) Nursing Considerations
Live Bedside Report Medsurg (Medical surgical)
Liver Cancer
Liver/Gallbladder Module Intro
Local Anesthesia
Loperamide (Imodium) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lower Gastrointestinal (GI) Module Intro
Lung Cancer
Lung Diseases Module Intro
Lymphatic Assessment
Lymphoma
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Malignant Hyperthermia
Mammogram
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Mechanical Aids
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Melanoma
Meniere’s Disease
Meperidine (Demerol) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
MI Surgical Intervention
Migraines
Miscellaneous Nerve Disorders
Mobility & Assistive Devices
Moderate Sedation
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Multiple Myeloma
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Musculoskeletal Assessment
Musculoskeletal Course Introduction
Musculoskeletal Module Intro
Myocardial Infarction (MI) Case Study (45 min)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Naproxen (Aleve) Nursing Considerations
Nasal Disorders
Neostigmine (Prostigmin) Nursing Considerations
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro A&P Module Intro
Neuro Anatomy
Neuro Assessment Module Intro
Neuro Course Introduction
Neuro Disorders Module Intro
Neuro Trauma Module Intro
Neurological Fractures
NG (Nasogastric)Tube Management
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
NRSNG Live | So You Want to be a Surgical Nurse?
Nuclear Medicine
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Chlamydia (STI)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Epididymitis
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Osteomyelitis
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Testicular Torsion
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Pneumonia
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Bell’s Palsy
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Bladder Cancer
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Breast Cancer
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cervical Cancer
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Dementia
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epididymitis
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Gout / Gouty Arthritis
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthermia (Thermoregulation)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lung Cancer
Nursing Care Plan (NCP) for Lyme Disease
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Meniere’s Disease
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Ovarian Cancer
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Polycystic Ovarian Syndrome (PCOS)
Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)
Nursing Care Plan (NCP) for Prostate Cancer
Nursing Care Plan (NCP) for Psoriasis
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)
Nursing Care Plan (NCP) for Stroke (CVA)
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Testicular Cancer
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Thyroid Cancer
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for West Nile Virus
Nursing Care Plan for (NCP) Trigeminal Neuralgia
Nursing Care Plan for Amputation
Nursing Care Plan for Chlamydia (STI)
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Compartment Syndrome
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Endometriosis
Nursing Care Plan for Fibromyalgia
Nursing Care Plan for Fractures
Nursing Care Plan for Gastritis
Nursing Care Plan for Gonorrhea (STI)
Nursing Care Plan for Hemorrhoids
Nursing Care Plan for Herpes Simplex (HSV, STI)
Nursing Care Plan for Hiatal Hernia
Nursing Care Plan for Liver Cancer
Nursing Care Plan for Macular Degeneration
Nursing Care Plan for Myocarditis
Nursing Care Plan for Nasal Disorders
Nursing Care Plan for Osteomyelitis
Nursing Care Plan for Pelvic Inflammatory Disease (PID)
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan for Scleroderma
Nursing Care Plan for Syphilis (STI)
Nursing Care Plan for Testicular Torsion
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Breast Cancer
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Colon Cancer
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Hepatitis
Nursing Case Study for Pneumonia
Nursing Case Study for Rheumatic Heart Disease
Nursing Case Study for Rheumatoid Arthritis
Nursing Case Study for Type 1 Diabetes
Nursing Skills Course Introduction
Nutrition (Diet) in Disease
Nutrition-related Diseases
Omeprazole (Prilosec) Nursing Considerations
Oncology Important Points
Oncology Module Intro
Oncology nurse
Ondansetron (Zofran) Nursing Considerations
Opioids
Osteosarcoma
Ovarian Cancer
Oxygen Delivery Module Intro
Pacemakers
Pain and Nonpharmacological Comfort Measures
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Pain Assessments for Certified Perioperative Nurse (CNOR)
Pantoprazole (Protonix) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Patient Positioning
Patients with Communication Difficulties
Pentobarbital (Nembutal) Nursing Considerations
Peptic Ulcer Disease Case Study (60 min)
Performing Cardiac (Heart) Monitoring
Perioperative Nursing Course Introduction
Perioperative Nursing Roles
Peripheral Vascular Assessment
Peritoneal Dialysis (PD)
Phenazopyridine (Pyridium) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Phosphorus (PO4) Blood Test Lab Values
Pituitary Adenoma
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Pneumonia Concept Map
Pneumonia Labs
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Positioning
Post-Anesthesia Recovery
Postoperative (Postop) Complications
PPE Donning & Doffing
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Pressure Line Management
Pressure Ulcers/Pressure injuries (Braden scale)
Procalcitonin (PCT) Lab Values
Propofol (Diprivan) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Prostate Cancer
Prostate Nursing Mnemonic (FUN)
Prostate Specific Antigen (PSA) Lab Values
Protein in Urine Lab Values
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Radiation Cancer Treatment
Ranitidine (Zantac) Nursing Considerations
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory A&P Module Intro
Respiratory Alkalosis
Respiratory Course Introduction
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Trauma Module Intro
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Rifampin (Rifadin) Nursing Considerations
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
Routine Neuro Assessments
Science of Nutrition
Scleroderma Symptoms Nursing Mnemonic (CREST)
Sedatives-Hypnotics
Sedatives-Hypnotics
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Sepsis Concept Map
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Specialty Diets (Nutrition)
Spinal Cord Injury
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Strabismus
Streptokinase (Streptase) Nursing Considerations
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Case Study (45 min)
Stroke Concept Map
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Sucralfate (Carafate) Nursing Considerations
Supraventricular Tachycardia (SVT)
Surgical Incisions & Drain Sites
Surgical Prep
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
Systemic Lupus Erythematosus (SLE)
TB Drugs Nursing Mnemonic (RIPE)
Tension and Cluster Headaches
Testicular Cancer
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
The Medical Team
Thoracentesis
Thrombin Inhibitors
Thrombocytopenia
Thrombolytics
Thyroid Cancer
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Total Iron Binding Capacity (TIBC) Lab Values
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Triiodothyronine (T3) Lab Values
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Ultrasound
Understanding Blood Pressure Meds! – Live Tutoring Archive
Upper Gastrointestinal (GI) Module Intro
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Urine Culture and Sensitivity Lab Values
Using Aseptic Technique
Vancomycin (Vancocin) Nursing Considerations
Varicocele
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasopressin
Vasopressin (Pitressin) Nursing Considerations
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Wound Drains
Seizure Documentation Nursing Mnemonic (TDOC)