Hydronephrosis

Hydronephrosis is dilation of the renal collecting system, involving the renal pelvis and calyces. Think of it as a plumbing clue seen on a scan. The kidney keeps making urine, the urine has trouble leaving, and the space upstream of the problem stretches. That picture explains the most important idea in this topic: hydronephrosis is a finding, not a diagnosis of the underlying cause. A report that says "moderate left hydronephrosis" tells you that something may be wrong with drainage. It does not tell you why, whether the kidney is being harmed, or how fast you need to move. It commonly develops when urinary drainage is impaired, although dilation can occur without clinically significant obstruction. The reverse also happens. Early in an obstruction the collecting system has not yet had time to stretch, so obstruction may occur before hydronephrosis becomes visible. A scan can therefore over-call or under-call the problem, and the patient in front of you decides what the image means. Three questions turn the finding into a nursing plan: 1. Is the system infected? Infection combined with urinary...