Left distal ureteral lithiasis: A clinical case and proposal for a comprehensive perioperative nursing approach

Abstract

Urinary lithiasis is a pathology of high global and regional prevalence, representing an epidemiological challenge in the province of Manabí, Ecuador. When the stones migrate to the distal ureter, the resulting mechanical obstruction triggers severe symptoms and imminent risk of renal dysfunction and infection, requiring minimally invasive approaches and strict perioperative nursing monitoring. Objective: To develop a comprehensive and individualized nursing care plan for a patient with a diagnosis of left distal lithiasis and a history of urethral stricture, scheduled for a left ureteroscopy with laser lithotripsy. Methodology: The Nursing Care Process (PAE) structured in its five consecutive phases was applied, the collection of clinical data was carried out through documentary review, cephalocaudal physical examination and complementary examinations. Four priority diagnoses were formulated: Acute pain, Risk of infection, Risk of deterioration of urinary elimination, and Anxiety. After the implementation of the targeted interventions, the patient manifested a substantial reduction in pain, stability in hemodynamic constants, absence of infectious manifestations, maintenance of urinary flow, and a notable mitigation of preoperative anxiety levels. Conclusions: The systematic application of ECP in perioperative urological care optimizes clinical safety, reduces the rate of secondary morbidity and mortality, and consolidates the methodological and scientific rigor of professional nursing practice in complex hospital environments.