Following a ureterolithotomy, the client has a ureteral catheter in place. Which intervention should the nurse implement?

Choice A reason: Comparing vital signs to baseline may show tachycardia from pain-induced sympathetic activation, but this is non-specific, as fever or anxiety can mimic these. Pain is subjective, involving nociceptor signaling, and the client’s direct intensity description provides the most accurate severity measure, guiding targeted treatment.

Choice B reason: Reviewing medical history provides pain context but not current severity. Pain perception involves spinal and cortical nociceptive pathways, and only the client’s description quantifies intensity. Historical data informs diagnosis, but direct assessment is more precise for evaluating present pain, ensuring appropriate analgesic intervention.

Choice C reason: Noting analgesic frequency suggests pain control needs but not current severity. Frequent dosing may indicate tolerance or inadequate relief, not intensity. Pain’s subjective nature, mediated by neural pathways, requires the client’s report to assess severity accurately, guiding dosing over indirect medication usage patterns.

Choice D reason: Asking the client to describe pain intensity directly captures their subjective experience, mediated by nociceptors and cortical perception. Using a 0–10 scale quantifies severity, guiding precise analgesia. This is most effective, as pain is personal, ensuring accurate assessment and tailored treatment to alleviate discomfort effectively.

Choice A reason: Using a heating pad is contraindicated in Raynaud’s, as reduced sensation from vasospasm risks burns. Raynaud’s involves cold-triggered arteriolar constriction, reducing blood flow. Heat does not address vasospasm’s pathophysiology and may cause tissue damage, making this instruction inappropriate compared to cold protection strategies.

Choice B reason: Wearing gloves when handling cold items prevents vasospasm in Raynaud’s, where cold triggers arteriolar constriction, causing ischemia and pain. Protecting extremities maintains blood flow, preventing episodes. This directly addresses the disease’s pathophysiological trigger, making it the most effective instruction for managing Raynaud’s symptoms.

Choice C reason: Knee-high support stockings improve venous return, relevant for venous insufficiency, not Raynaud’s arterial vasospasm. Stockings do not prevent cold-induced vasoconstriction, the primary trigger. Gloves for cold exposure directly mitigate vasospastic episodes, making this instruction less effective for Raynaud’s disease management.

Choice D reason: Regular walking improves overall circulation but does not prevent Raynaud’s vasospastic episodes, triggered by cold or stress. While exercise supports vascular health, avoiding cold exposure with gloves is more targeted, directly reducing arteriolar constriction and ischemic symptoms, making walking a secondary recommendation.