Postoperatively, Patients’ discomforts e.g. pain, nausea and anxiety,
during the recovery period are more profound and interferes with the ability to
return to normal activities such as shopping and work outside the home (Rosén,
Bergh, Lundman and Mårtensson, 2010).
Postoperative recovery is energy requiring process of returning to normality
and wholeness as defined by comparative standards, achieved by regaining
control over physical, psychological, social, and spiritual functions, which
results in returning to preoperative levels of independence/dependence in
activities of daily living and an optimum level of psychological well-being (Allvin, Berg, Idvall and Nilsson,
Relieving pain and anxiety: Adequate attention to pain relief can help in
promoting a feeling of wellbeing which has a positive influence on
postoperative outcome (Venkateswaran and Prasad,
2010). Opioid analgesics are administered
judiciously and often intravenously in the post anesthesia care unit (PACU).
Intravenous opioids provide immediate relief and are short-acting, thus
minimizing the potential for drug interactions or prolonged respiratory
depression while anesthetics are still active in the patients’ system. In addition
to monitoring the patients’ physiologic status and managing pain, the PACU
nurse provides psychological support in an effort to relieve the patient’s
fears and concerns (Meeker and Rothrock, 2011).
vomiting: Post-operative nausea and vomiting are
common problems after general anesthesia, caused by unrelieved pain especially
visceral and the opioids that stimulate nausea and vomiting by a direct action
on the chemoreceptor trigger zone (CTZ). Adequate pain relief reduces the
occurrence of nausea by 80% (Barroso,
Resuming activities of daily living: Recovery from ureteroscopy is much faster and exercise can be continued
sooner, so avoiding heavy activities for the first 24 to 48 hours, however,
walking during this time is essential and starts slowly. Increasing activities
should be done according to body ability. Patients should avoid strenuous
activities for three to five days (Parepalo,
importance of follow-up to assess kidney function and to ensure the eradication or removal of
all kidney stones is emphasized to the patient and family. If the patient
underwent Ureteroscopic Lithotripsy, the nurse must provide instructions for
home care and necessary follow-up. The patient is encouraged to increase fluid
intake to assist in the passage of stone fragments, which may occur for 6 weeks
to several months after the procedure. The patient and family are instructed
about signs and symptoms that indicate complications, such as fever, decreasing
urine output, and pain. It is also important to tell the patient to expect
hematuria (it is anticipated in all patients), but it should disappear within 4
to 5 days, If the patient has a stent in the ureter, hematuria may be expected
until it is removed (Schlosshan
et al., 2011).
Postoperative Evaluation: It is expected that the patient will
experience the following: relieve pain, reduce anxiety, complications absent,
physical mobility and understanding of self-care routines will improve (Lewis,
Heitkemper, and Dirksen, 2011).
guidelines for Patient with ureter stones
Finish your entire prescription of antibiotics to
ensure that you will not get a
urinary tract infection.
You may resume your usual daily activities remember to
balance regular exercise with sleep and rest .
You may return to work two days to sex weeks after
procedure depending on the type of intervention, your personal tolerance and
Depending on the type of stone you had, your diet
restricted to prevent farther stone formation.
Remember to drink at least 3L of fluid a day to dilute
potential stone forming crystals, prevent dehydration promote urine flow.
Monitor urine PH as directed (possibly up to 3 times
per day) , Expect perusing after lithotripsy.
The perusing may be quite extensive and may take
several weeks to resolve.
Your urine may be bloody for several days after
Pain in the region of the kidney or bladder may signal
the beginning of an infection or the formation of another stones, report any
pain, fever, chills or difficulty of urination immediately to your physician or
Keep follow up appointments to check on infection and
have repeat cultures done.
(Resim et al., 2011).