A client is scheduled to undergo extracorporeal shock wave lithotripsy (ESWL) for the treatment of kidney stones. What should the nurse include in the preoperative education for the client?
"ESWL is an invasive surgical procedure that requires a hospital stay."
"You may experience some discomfort during the procedure, but it will be done under general anesthesia."
"After the procedure, you will need to avoid all fluids for 24 hours."
"ESWL uses shock waves to break up kidney stones, and you will need to stay still during the procedure."
The Correct Answer is D
A. ESWL is a non-invasive procedure, and it does not require a hospital stay. It is typically performed on an outpatient basis.
B. This is not entirely accurate. ESWL is a non-invasive procedure that does not require general anesthesia. Instead, the client may be given sedation or local anesthesia.
C. It is essential to maintain adequate hydration after ESWL to help pass the broken-up stone fragments. Avoiding all fluids for 24 hours is not recommended and may lead to dehydration.
D. This is the correct answer. ESWL uses shock waves to break up kidney stones, and the client will need to remain still during the procedure to ensure precise targeting of the stones. The procedure is usually painless, but some discomfort may be experienced during the process.
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Correct Answer is C
Explanation
A. Uric acid stones may cause pain, but they do not typically present with costovertebral angle tenderness. Uric acid stones are more likely to be associated with gout and hyperuricemia.
B. Calcium oxalate stones are common and can cause pain, but they do not typically cause costovertebral angle tenderness. They are more likely to cause localized pain in the back or side.
C. This is the correct answer. Struvite stones, also known as infection stones, can cause severe pain that radiates to the back and lower abdomen. They are often associated with urinary tract infections, and the presence of an infection can lead to costovertebral angle tenderness.
D. Cystine stones are rare and are more likely to cause chronic, dull pain rather than sudden and severe pain with tenderness.
Correct Answer is ["A"]
Explanation
A. This is the correct answer. After percutaneous nephrolithotomy (PCNL), the client may experience urinary retention due to swelling and irritation around the bladder or urethra from the procedure. The nurse should monitor the client for signs of urinary retention, such as difficulty urinating or a distended bladder, and take appropriate measures to relieve the obstruction.
B. Hyperkalemia is not directly related to PCNL. It may occur in certain medical conditions but is not a common complication of this procedure.
C. Hypoglycemia is not related to PCNL. It is a condition related to low blood sugar levels and is not a typical complication of kidney stone removal.
D. Hypertension is not directly related to PCNL. While some clients with hypertension may be at increased risk for kidney stones, hypertension is not a common complication of PCNL itself.
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