A nurse is providing postoperative care instructions to a client who underwent ureteroscopy for the removal of a kidney stone. Which of the following statements by the client indicates a need for further teaching?

A. Diarrhea and abdominal cramping are not typically associated with kidney stone pain. These symptoms are more commonly seen in gastrointestinal disorders.

B. Painful and frequent urination may occur if the stone causes irritation in the bladder or urethra, but it is not a direct symptom of kidney stone pain.

C. Fatigue and generalized weakness are not specific symptoms of kidney stone pain. They may be associated with other medical conditions but are not directly related to renal calculus.

D. This is the correct answer. Nausea and vomiting are common symptoms that may accompany kidney stone pain, especially if the stone causes obstruction in the urinary tract. The pain and irritation can trigger a reflex that leads to nausea and vomiting.

A. Extracorporeal shock wave lithotripsy (ESWL) does not typically require general anesthesia. It is usually done under sedation or with the use of local anesthesia.

B. The procedure does not involve the insertion of a scope into the urinary tract. ESWL is a non-invasive procedure that uses shock waves to break up the stone from outside the body.

C. This is the correct answer. ESWL involves the use of high-energy shock waves that are focused on the stone to break it up into smaller fragments. The fragments are then passed out of the body through the urine.

D. A urinary catheter is not typically required after ESWL. The client may be encouraged to drink plenty of fluids to help flush out the stone fragments, but a catheter is not usually needed.

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