A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

Manage bladder irrigation following the procedure.

Administer a bolus of 750 mi. normal saline following the procedure

Strain the client's urine following the procedure.

Insert a urinary catheter for 24 to 48 hours after the procedure.

Answer and Explanation

The Correct Answer is C

A. Manage bladder irrigation following the procedure. - Bladder irrigation is not typically performed after ESWL. It may be used in other urological procedures, but it is not a standard post-procedural care for ESWL.

B. Administer a bolus of 750 mL normal saline following the procedure. - While maintaining hydration is important, there is no specific requirement for a bolus of normal saline after ESWL. Hydration is usually encouraged, but the amount and method of administration are determined based on the client's overall fluid status and medical condition.

C. Strain the client's urine following the procedure.
After extracorporeal shock wave lithotripsy (ESWL), it is essential to strain the client's urine to collect any stone fragments. Straining allows healthcare providers to analyze the composition of the stones, ensuring that all fragments have been passed. This information helps in assessing the effectiveness of the procedure and guides further management.

D. Insert a urinary catheter for 24 to 48 hours after the procedure. - Inserting a urinary catheter is not a routine post-procedural measure after ESWL. Catheterization might be necessary in certain situations or for specific medical reasons, but it is not a standard practice after ESWL for all clients.

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Correct Answer is D

Explanation

A. Void every 6 to 8 hours:This interval may not be frequent enough. It is generally recommended to void every 2 to 3 hours to help flush out bacteria and reduce the risk of infection.

B. Avoid voiding immediately after sexual intercourse.This is not recommended. It is actually advised to void immediately after sexual intercourse to help flush out any bacteria that may have entered the urethra.

C. Take a bubble bath daily and keep the perineal region clean:
While keeping the perineal region clean is important for general hygiene, taking bubble baths and using heavily scented products can irritate the urethra and potentially increase the risk of UTIs. The nurse should advise against frequent bubble baths and suggest using mild, unscented soaps for the perineal area.

D. Increase the daily amount of water consumed:
Drinking more water helps increase urine output, which helps flush out bacteria from the urinary tract and can reduce the risk of recurrent UTIs.

A. "Pyelonephritis increases a person's risk for kidney damage." B. "Pyelonephritis is an infection of the lower urinary tract." C. "Pyelonephritis often causes no symptoms in affected clients." D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus."

Correct Answer is A

Explanation

A. "Pyelonephritis increases a person's risk for kidney damage." - Pyelonephritis is a bacterial infection of the renal parenchyma and renal pelvis, typically caused by the ascent of bacteria from the lower urinary tract into the kidneys. If left untreated, it can lead to kidney damage, including scarring of the renal tissue and impaired kidney function.

B. "Pyelonephritis is an infection of the lower urinary tract." - This statement is incorrect. Pyelonephritis specifically involves the upper urinary tract, affecting the kidneys. In contrast, infections of the lower urinary tract (such as cystitis) affect the bladder and urethra.

C. "Pyelonephritis often causes no symptoms in affected clients." - This statement is incorrect. Pyelonephritis typically presents with symptoms such as fever, chills, flank pain, painful urination (dysuria), and frequent urination. Clients with pyelonephritis usually experience noticeable symptoms.

D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus." - This statement is incorrect. While Staphylococcus saprophyticus is a common cause of urinary tract infections, pyelonephritis is more commonly caused by gram-negative bacteria, such as Escherichia coli, which often ascend from the lower urinary tract into the kidneys.

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A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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