Which nursing diagnosis best applies to a patient with renal calculi?

• A. Ineffective tissue perfusion
• B. Risk for infection
• C. Decreased cardiac output
• D. Functional urinary incontinence

Answer: (B)

When a renal calculus obstructs the urinary tract, urine can become stagnant above the blockage. Stasis and obstruction create an environment that readily supports bacterial growth, so infection becomes a key potential complication. The nursing focus that best fits this scenario is risk for infection because preventing and detecting urinary infections early is essential in someone with stones and possible obstruction.

In practice, the nurse would monitor for signs of infection such as fever, chills, tachycardia, foul-smelling or cloudy urine, and flank or groin pain, and promote measures that reduce infection risk—adequate hydration to help flush the urinary tract, careful catheter care if needed, and prompt assessment and treatment of any suspected infection.

The other options don’t align as closely with the common complications of renal calculi: perfusion issues aren’t the primary concern with stones, decreased cardiac output is unrelated to the urinary obstruction scenario, and functional urinary incontinence isn’t a typical consequence of renal calculi.