A nurse is planning care for a client who has renal stones and a urinary catheter in place.
Which of the following interventions should the nurse include in the plan of care?
A.
Maintain the client on bed rest.
B.
Strain the client’s urine through a mesh filter.
C.
Encourage fluid intake of 1500 mL/day.
D.
Clamp the urinary catheter every 2 hr.
The correct answer and Explanation is :
The correct intervention for a client with renal stones and a urinary catheter is:
B. Strain the client’s urine through a mesh filter.
Explanation:
Clients with renal stones (kidney stones) need careful monitoring to assess for the passage of stones and prevent complications like obstruction or infection. Straining the urine through a mesh filter is essential to identify whether the client is passing stones or stone fragments. When the urine is strained, any stones that are collected can be sent for analysis to determine their composition. This information helps guide future treatment and prevention strategies.
Incorrect Options:
- A. Maintain the client on bed rest.
Bed rest is not typically necessary for clients with renal stones unless they have another complicating condition that requires it. In fact, mobility may help facilitate the movement and eventual passage of stones. Early ambulation is often encouraged to promote normal urinary flow and prevent complications like urinary stasis and infection. - C. Encourage fluid intake of 1500 mL/day.
While encouraging fluid intake is a critical component of managing renal stones, 1500 mL/day is insufficient. The goal is typically much higher, around 2,000-3,000 mL/day, to help flush out small stones and prevent new stones from forming. Adequate hydration helps dilute the urine, reducing the risk of stone formation. - D. Clamp the urinary catheter every 2 hr.
Clamping a urinary catheter in this situation is inappropriate and could increase the risk of urinary retention and infection. It could also prevent the proper drainage of urine, potentially exacerbating symptoms and delaying the identification of any stones passed. Catheters should be kept patent and draining freely to prevent complications.
In summary, straining the urine helps monitor the client’s progress in passing stones and enables appropriate treatment based on the type of stone present. Other interventions like adequate hydration and ensuring proper catheter drainage are also crucial in managing renal stones.