Boom Boom
A client presents to the emergency department with severe, colicky left-flank pain, nausea, and diaphoresis. Which of the following is the nurse's priority nursing intervention?
A. Strain all urine through a gauze or stone strainer.
B. Encourage oral fluid intake of 500 mL/hr.
C. Administer prescribed opioid analgesic and antiemetic medications.
D. Obtain a baseline 24-hour urine collection.
C. Administer prescribed opioid analgesic and antiemetic medications.
Correct! Alleviating severe renal colic pain and controlling nausea are the immediate clinical priorities using the nursing process and ABC/comfort framework.
A nurse is providing discharge education to a client with a newly diagnosed calcium oxalate renal calculus. Which of the following foods should the nurse instruct the client to limit?
A. Spinach and strawberries
B. Cottage cheese and milk
C. Chicken breast and eggs
D. Apples and white rice
A. Spinach and strawberries
Correct! Spinach, strawberries, nuts, chocolate, and tea are high in oxalates and should be restricted in clients with calcium oxalate stones.
A nurse is monitoring a client immediately following Extracorporeal Shock Wave Lithotripsy (ESWL). Which of the following findings is an expected post-procedure outcome?
A. Bright red, grossly bloody urine with large clots
B. Complete absence of urine output for 8 hours
C. Severe, rigid, board-like abdomen
D. Bruising and ecchymosis over the flank of the treated side
A. Bright red, grossly bloody urine with large clots
Incorrect. Mild hematuria is expected, but bright red urine with large clots indicates active hemorrhage or a complication.
B. Complete absence of urine output for 8 hours
Incorrect. Anuria or oliguria is a sign of obstruction or acute kidney injury and must be reported immediately.
C. Severe, rigid, board-like abdomen
Incorrect. A rigid abdomen indicates peritonitis or bowel injury, which is not an expected outcome.
D. Bruising and ecchymosis over the flank of the treated side
Correct! The high-energy shock waves travel through the skin and soft tissues to fragment the stone, frequently leaving mild ecchymosis or petechiae on the flank.
Which of the following clients has the highest cumulative risk for developing calcium-based renal calculi?
A nurse is teaching a client with a history of renal calculi about daily fluid management. What target fluid intake should the nurse recommend to maintain dilute urine?
A nurse is educating a client who forms uric acid stones about purine-restricted diets. Which of the following foods should the nurse advise the client to avoid?
A client who had a ureteral stent placed asks the nurse what sensations are normal during the first few days. Which statement by the nurse is accurate?
A nurse is assessing a client 4 hours post-lithotripsy. Which finding should be reported to the provider immediately?
A.Fever of 101.4°F (38.5°C) and chills.
B.Pink-tinged or bright red urine without large clots.
C.Minor discomfort on the treated flank side.
D.Small, sand-like stone fragments present in the urine strainer.
Correct Answer: Fever of 101.4°F (38.5°C) and chills. A fever and chills shortly after a urinary procedure indicate a urinary tract infection or urosepsis. This occurs when bacteria trapped behind or inside the stone are released into the bloodstream during fragment destruction. It requires immediate antibiotic intervention.
A nurse is reviewing the medication list for a client with recurrent uric acid renal calculi. Which of the following medications should the nurse anticipate the provider to prescribe to lower serum and urinary uric acid levels?
A. Furosemide
B. Allopurinol
C. Calcium carbonate
D. Aspirin
B. Allopurinol
A client presents with acute renal colic and is found to have a 7 mm stone obstructing the upper ureter. In addition to severe flank pain, which finding represents a medical emergency requiring immediate urologic intervention?
A client with a newly placed ureteral stent reports severe, cramping bladder spasms. Which medication is most appropriate for the nurse to anticipate?
Struvite (infection) renal calculi are characteristically associated with which of the following organisms?
A nurse is caring for a client 24 hours post-percutaneous nephrolithotomy (PCNL). Which of the following assessment findings requires immediate notification of the healthcare provider?
During a physical assessment of a client with a right-sided renal calculus, which finding does the nurse expect to elicit?