The nurse has taught a client with urinary incontinence about taking prescribed oxybutynin chloride.
Which of the following statements by the client would indicate a correct understanding of the teaching?

Choice A rationale

A low sodium, high-calorie diet does not directly address severe pain caused by renal colic. Dietary interventions are long-term strategies for kidney health but are not immediate priorities for acute pain relief. Renal colic pain requires prompt management with pharmacological interventions to alleviate severe discomfort. Adjusting dietary intake may support prevention but would not resolve the acute symptoms, emphasizing that this is not the first-line measure for this clinical situation.

Choice B rationale

Increasing fluid intake to 3–4 L/day is beneficial for flushing out kidney stones and preventing further stone formation. However, this intervention does not directly alleviate severe pain experienced during an episode of renal colic. While adequate hydration is crucial for long-term management, acute pain demands immediate pharmacological relief. Therefore, fluid intake implementation is secondary when compared to pain management priorities.

Choice C rationale

Tamsulosin (Flomax) is an alpha-blocker that promotes the passage of kidney stones by relaxing the smooth muscles of the ureter. Although effective in expediting stone passage, it does not provide immediate pain relief for severe renal colic. Its role is valuable for the resolution of the obstruction but does not address acute symptoms. Administering pain medication remains a priority to manage distress caused by colic episodes.

Choice D rationale

Morphine sulfate is an opioid analgesic that directly targets severe pain associated with renal colic. It binds to mu-opioid receptors in the central nervous system, producing analgesia and a calming effect. Its rapid onset and effectiveness in severe pain management make it the first prescription to implement. Pain relief improves the client's comfort and allows for addressing underlying causes of colic after stabilizing acute distress.

Choice A rationale

Hemorrhage is not a typical complication of extracorporeal shock wave lithotripsy (ESWL), as it is a non-invasive procedure targeting kidney stones using shock waves. The risk of significant bleeding is minimal, and monitoring focuses more on urinary changes or localized pain rather than hemorrhage.

Choice B rationale

ESWL does not involve surgical incisions, so there is no incision site to monitor for infection. This action is irrelevant to the procedure's mechanism, which uses external shock waves to fragment stones rather than invasive surgical methods.

Choice C rationale

Sand or gravel in the urine is a common finding after ESWL as the procedure fragments kidney stones into smaller particles. These fragments are excreted through the urinary system. Monitoring urine for these particles helps evaluate the procedure's effectiveness and ensure stones are adequately eliminated.

Choice D rationale

Percutaneous nephrostomy tubes are used for urinary drainage but are not a standard component of ESWL. Monitoring for tube obstruction applies to invasive procedures, whereas ESWL focuses on non-invasive stone fragmentation. This action is unrelated to the client's current treatment modality. .