Which nursing diagnosis is most appropriate for a client with renal calculi?

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

Answer: (C)

Blockage from renal calculi disrupts normal urine flow and creates urinary stasis, which is a prime environment for bacteria to grow. That makes the risk for infection the most appropriate nursing diagnosis here, because infection can readily develop when urine is not draining properly and bacteria can ascend the urinary tract, potentially leading to pyelonephritis or urosepsis if not detected and treated. Clinically, you’d monitor for fever, chills, flank or groin pain, dysuria, and changes in urine; ensure adequate hydration as ordered and follow any cultures or antibiotic therapy if indicated.

The other options don’t fit as well. Ineffective tissue perfusion is more about blood flow to tissues and isn’t the primary concern with stones, unless there’s a specific renal ischemic complication. Functional urinary incontinence reflects bladder control issues rather than obstruction and stone-related pathology. Decreased cardiac output is a systemic cardiovascular concern that isn’t directly driven by the presence of renal calculi.