Nursing staff on a hospital unit are reviewing rates of health care-associated infections (HAI) of the urinary tract. Which nursing action will be most helpful in decreasing the risk for urinary HAI in patients admitted to the hospital?

A. Protein in the urine: Proteinuria is generally a sign of kidney damage or other renal conditions. While underlying kidney disease may coexist with stone formation, protein in the urine does not directly increase the risk of stone development.

B. Iron deficiency: Iron deficiency affects hemoglobin production and overall oxygen-carrying capacity but has no direct correlation with the development of renal calculi. Nutritional deficiencies like iron deficiency do not contribute to the crystallization of minerals in the urinary tract.

C. Dehydration: Dehydration reduces urine volume and increases the concentration of minerals and solutes in the urine, which can precipitate and form renal calculi. Adequate fluid intake dilutes urine and lowers the risk of stone formation, making hydration a key preventive measure for clients with urolithiasis.

D. Obesity: While obesity is associated with metabolic changes that can indirectly influence stone formation, it is not a direct cause of renal calculi. The primary modifiable risk factor that increases the likelihood of stones is concentrated urine due to insufficient fluid intake.

A. Hematuria: The presence of blood in the urine is expected for the first few days after extracorporeal shock wave lithotripsy. It results from trauma to the urinary tract and usually resolves on its own, so it does not require urgent reporting unless it becomes severe or prolonged.

B. Oliguria: Decreased urine output is the most concerning finding because it may indicate obstruction from stone fragments or acute kidney injury. This complication can quickly compromise renal function and requires immediate evaluation by the healthcare provider.

C. Ecchymosis in left flank: Bruising around the flank is a common side effect of the shock waves used during lithotripsy. While it may be uncomfortable, it is not considered dangerous and does not require urgent intervention.

D. Left flank discomfort: Pain is expected after the procedure due to both the passage of stone fragments and localized tissue trauma. Analgesics are typically used to manage this symptom, and it is not considered a critical finding to report.