Hydronephrosis

Definition

Hydronephrosis is the swelling of one or both kidneys caused by a backup of urine from obstruction of the urinary tract. Untreated, it can cause kidney damage or failure.

Causes

• Kidney stones
• Benign prostatic hyperplasia (BPH)
• Pregnancy (compression)
• Tumors
• Urethral strictures
• Congenital obstruction
• Neurogenic bladder

Signs and Symptoms

Flank or back pain (may be severe and colicky for stones), nausea/vomiting, hematuria, UTI symptoms, decreased urine output with bilateral obstruction, often asymptomatic until advanced.

Nursing Interventions

Monitor I&O, pain management, assist with diagnostic workup (renal ultrasound, CT). Relieve obstruction: catheterization, ureteral stent, percutaneous nephrostomy, or surgery. Strain urine if stones suspected. Encourage fluid intake (unless contraindicated). Monitor renal function (BUN, creatinine, urine output).

NCLEX Relevance

Priority: relieve obstruction to preserve kidney function.