A nurse is admitting a client who reports recurrent flank pain and nausea for 24 hr. Which of the following actions should the nurse take first?

Choice A rationale
Telling the client to expect a decrease in urine output is incorrect because it may indicate dehydration, obstruction, or infection. Clients with urolithiasis should be encouraged to maintain adequate urine output to help flush out stones and prevent new stone formation. Decreased urine output can lead to complications and should be addressed promptly.
Choice B rationale
Providing the client with a high protein diet is incorrect because it may increase uric acid and calcium excretion, which can promote stone formation. Clients with urolithiasis should follow a balanced diet that is low in substances that can contribute to stone formation, such as oxalates, purines, and excessive calcium.
Choice C rationale
Maintaining the client on bed rest is incorrect because it may decrease renal perfusion and increase urinary stasis. Clients with urolithiasis should be encouraged to stay active and mobile to promote better circulation and prevent complications. Bed rest is not typically recommended unless there are specific medical indications for it.
Choice D rationale
Encouraging the client to drink 3 L of fluids per day is correct because it helps to flush out stones, prevent new stone formation, and reduce urinary concentration. Adequate hydration is essential for clients with urolithiasis to maintain proper kidney function and reduce the risk of complications. Drinking plenty of fluids helps to dilute the urine and promote the passage of stones.

Choice A rationale
Warm extremities are not typically associated with peripheral arterial disease (PAD). PAD usually results in reduced blood flow, leading to cooler extremities.
Choice B rationale
Darkened skin color near extremities is more commonly associated with venous insufficiency rather than PAD. PAD typically causes pale or bluish skin due to reduced blood flow.

Choice C rationale
Intermittent claudication, which is pain or cramping in the legs during exercise that subsides with rest, is a hallmark symptom of PAD. It occurs due to reduced blood flow to the muscles during activity.
Choice D rationale
Edema is more commonly associated with venous insufficiency or heart failure rather than PAD. PAD typically causes reduced blood flow, not fluid accumulation.