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 C

Explanation

A. Avoiding the use of ice packs to treat muscle pain - While ice packs can cause skin damage in older adults with thinning skin, it is not the most appropriate response to the question. Protecting against shearing injuries is a more direct and specific concern related to thinning skin.

B. Protecting older adults against excessive sweat accumulation - Excessive sweat accumulation can lead to skin irritation, but this option does not directly address the issue of thinning skin as the primary concern in the question.

C. By protecting older adults against shearing injuries
Thinning skin in older adults makes them more vulnerable to skin injuries, especially shearing injuries. Shearing occurs when the skin is pulled in one direction while the underlying bone and tissues are pulled in the opposite direction. This can lead to skin tears and other wounds, which can be painful and slow to heal in older adults. Nurses should take special precautions to prevent shearing injuries, such as using lift sheets or sliding devices when moving patients, and ensuring that patients are repositioned frequently to reduce friction and shearing forces.

D. Avoiding the use of lotion on older adults' skin - Proper moisturization of the skin is important, especially in older adults, to prevent dryness and skin breakdown. Avoiding lotion is not a recommended practice; instead, choosing appropriate, non-irritating lotions can help maintain skin integrity.

A. increased urinary output B. Decreased WBC's C. Increased uric and D. Decreased bladder pain/spasms

Correct Answer is D

Explanation

A. Increased urinary output: Phenazopyridine (Pyridium) does not directly impact urinary output. Its primary function is to provide relief from urinary pain, burning, and discomfort associated with urinary tract infections (UTIs) or other urinary conditions. It does not affect the amount of urine a person produces.

B. Decreased WBC's: Phenazopyridine does not directly influence white blood cell count (WBCs). WBC count is an indicator of the body's immune response and is typically used to assess the presence of infection. Phenazopyridine provides symptomatic relief but does not affect the underlying infection or the body's immune response to it.

C. Increased uric acid: Phenazopyridine does not affect uric acid levels. Uric acid is a waste product that is excreted by the kidneys. Elevated uric acid levels can be associated with conditions like gout, but Phenazopyridine does not have any direct impact on these levels.

D. Decreased bladder pain/spasms: Phenazopyridine is intended to relieve symptoms such as bladder pain, spasms, burning sensation, and discomfort experienced during urination. Therefore, the effectiveness of Phenazopyridine is indicated by a reduction in these symptoms. If the patient reports a decrease in bladder pain and spasms, it suggests that the medication is working to alleviate the discomfort associated with urinary tract issues.

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