A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

Manage bladder irrigation following the procedure.

Administer a bolus of 750 mi. normal saline following the procedure

Strain the client's urine following the procedure.

Insert a urinary catheter for 24 to 48 hours after the procedure.

Answer and Explanation

The Correct Answer is C

A. Manage bladder irrigation following the procedure. - Bladder irrigation is not typically performed after ESWL. It may be used in other urological procedures, but it is not a standard post-procedural care for ESWL.

B. Administer a bolus of 750 mL normal saline following the procedure. - While maintaining hydration is important, there is no specific requirement for a bolus of normal saline after ESWL. Hydration is usually encouraged, but the amount and method of administration are determined based on the client's overall fluid status and medical condition.

C. Strain the client's urine following the procedure.
After extracorporeal shock wave lithotripsy (ESWL), it is essential to strain the client's urine to collect any stone fragments. Straining allows healthcare providers to analyze the composition of the stones, ensuring that all fragments have been passed. This information helps in assessing the effectiveness of the procedure and guides further management.

D. Insert a urinary catheter for 24 to 48 hours after the procedure. - Inserting a urinary catheter is not a routine post-procedural measure after ESWL. Catheterization might be necessary in certain situations or for specific medical reasons, but it is not a standard practice after ESWL for all clients.

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Correct Answer is A

Explanation

A. Inadequate immobilization: Proper immobilization is essential for fractured bones to heal correctly. Immobilization, often achieved through casts, splints, or other orthopedic devices, stabilizes the broken bone fragments, allowing them to fuse back together. If the immobilization is not sufficient or if the patient doesn't follow the prescribed immobilization protocol, there can be excessive movement at the fracture site, hindering the healing process.

B. Venous thromboembolism: Venous thromboembolism (VTE) refers to the formation of blood clots in veins, usually in the legs (deep vein thrombosis) that can travel to the lungs (pulmonary embolism). While VTE is a potential complication after a fracture, it is not a direct cause of delayed bone union.

C. Inadequate vitamin D intake: Vitamin D is essential for bone health as it helps the body absorb calcium, which is crucial for bone formation and maintenance. Inadequate vitamin D levels can weaken bones and impair the healing process, but it's not a common cause of delayed bone union unless there are severe deficiencies or underlying medical conditions.

D. Bleeding at the injury site: Bleeding at the injury site occurs immediately after the fracture and is a natural part of the body's response to injury. While excessive bleeding can lead to complications, it is not a likely cause of delayed bone union six weeks after the injury. In the early stages of healing, bleeding is replaced by the formation of a hematoma, which eventually transforms into a callus and aids in the bone healing process.

A. Sedentary lifestyle B. Long-term use of diuretics C. Prolonged stress D. Obesity

Correct Answer is A

Explanation

A. Sedentary lifestyle - Lack of weight-bearing exercise and physical activity is a significant risk factor for the development of osteoporosis. Weight-bearing exercises help maintain bone density and strength. Sedentary individuals are more prone to osteoporosis.

B. Long-term use of diuretics - Long-term use of certain medications, such as corticosteroids, can increase the risk of osteoporosis. Diuretics are not typically associated with osteoporosis risk, although some medications can affect bone health.

C. Prolonged stress - Chronic stress can have negative effects on overall health, but it is not a direct risk factor for osteoporosis.

D. Obesity - Obesity is generally considered a protective factor against osteoporosis. Individuals with higher body weight tend to have stronger bones due to the mechanical load placed on the bones, reducing the risk of osteoporosis.

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A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

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