Nursing Care Plan


After reviewing the role of vasa recta also knownas straight arteries in blood pressure regulation, Laura learnt thatit carries blood at a slower rate and that it is crucial incountercurrent exchange maintenance, which prevents concentrationgradients washout in the renal medulla. Again,Laura learnt that during a decrease in blood pressure, the kidneyundergoes physiological whereby the juxtaglomerular kidney cellssecretes rennin where it is converted to angiotensin I from plasmaprotein angiotensinogen, which in turn is changed to angiotensin II.Eventually, blood pressure is raised (Alexander, 2005). AngiotensinII constricts the blood all through the body thereby raisingthe pressure of the blood. Adrenal cortexfunctions by getting stimulated by angiotensin to secretealdosterone, which is a hormone which reduces output of urine byincreasing retention of sodium irons and water by the kidneys thusraising the blood volume (Watson, 2004).

From Mr. Lyons, it is evident that such symptoms reveal the kidneystones are found in the ureter causing ureter obstruction. Therationale behind the use of morphine sulfate 2 mg IVP/2 hours,buprofen 600 mg/6 hours, and normal salineat 200ml/hr is to restrict the amount of calcium in Mr. Lyons diet.Intake of these orders by Mr. Lyons increases the amount of urinewith calcium and uric acid. Intake of saline helps in increasingamount of calcium in urine. In addition,these orders help in reducing the amount ofparathormone production which is a factor that reduces the formationof stones in the ureter (Taneja, 2010).

Based on the composition of calcium of the stone,the nurse should include dietary teachings such as recommending 2 to4 g/day of sodium intake in the food, reduction of low-calcium intakein the food, reduction of oxalate-containing foods for examplestrawberries, spinach, tea peanuts, and rhubarb (Alexander, 2005).


Alexander, I. L. (2005). Urinary tract andkidney diseases and disorders sourcebook.Detroit, MI: Omnigraphics.

Taneja, S. S. (2010). Complications of urologicsurgery: Prevention and management. Philadelphia, PA:Saunders/Elsevier.

Watson, S. (2004). The urinary system. Westport, Conn:Greenwood Press.

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