Page 1859 - Saunders Comprehensive Review For NCLEX-RN

aspirin because of the risk for bleeding), and use dry
heat to abdomen and flank areas for comfort when
cysts are infected.
5. Prevent constipation from pressure of cysts on colon
by adequate fiber in diet, stool softeners, adequate
fluid intake, and exercise.
6. Prepare the client for percutaneous cyst puncture for
relief of obstruction or for draining an abscess.
7. Administer antihypertensives as prescribed.
8. Prevent and/or treat UTIs.
9. Prepare the client for dialysis or renal transplantation.
10. Encourage the client to seek genetic counseling.
11. Provide psychological support to the client and family.
12. Provide psychosocial support and genetic counseling
for family members without polycystic kidney disease
who may want to donate a kidney.
XIX. Hydronephrosis
A. Description (Fig. 54-5)
1. Distention of the renal pelvis and calices caused by an
obstruction of normal urine flow
2. The urine becomes trapped proximal to the
obstruction.
3. The causes include calculus, tumors, scar tissue, ureter
obstructions, and hypertrophy of the prostate.
B. Assessment
1. Hypertension
2. Headache

3. Colicky or dull flank pain that radiates to the

groin
C. Interventions
1. Monitor vital signs frequently.

2. Monitor for fluid and electrolyte imbalances,

including dehydration after the obstruction is
relieved.
3. Monitor for diuresis, which can lead to fluid depletion.
4. Monitor weight daily.
5. Monitor urine for specific gravity and albumin and
glucose levels.
6. Administer fluid replacement as prescribed.
7. Prepare the client for insertion of a nephrostomy tube
or a surgical procedure to relieve the obstruction if
prescribed.
XX. Renal Calculi
A. Description
1. Calculi are stones that can form anywhere in the

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