A nurse is caring for a client in the emergency department with a diagnosis of renal calculi. Which of the following areas of the renal system do most renal calculi begin forming?

Choice A reason: Decreasing the IV fluid infusion rate and limiting oral fluid intake may not be appropriate without further assessment, as the client's BUN level is elevated, which could indicate dehydration or renal impairment. The normal range for BUN is typically 7-20 mg/dL.

Choice B reason: Collecting a urine specimen for culture and sensitivity may be necessary if there is a suspicion of infection, but there is no indication of infection based solely on the provided lab values.

Choice C reason: Evaluating urine for amount and specific gravity can help assess the client's hydration status and kidney function, which is pertinent given the elevated BUN level and ongoing nausea and vomiting.

Choice D reason: Continuing routine care may not be appropriate because the BUN level is above the normal range, indicating that further assessment and intervention may be necessary.

Choice A reason: Flank pain is a common symptom of PKD due to the enlargement of cysts within the kidneys.

Choice B reason: Confusion is not a direct symptom of PKD but could be related to complications such as severe hypertension or toxins in the blood due to decreased kidney function.

Choice C reason: Hypotension is not typically associated with PKD; in fact, hypertension is a more common finding due to the disease's impact on kidney function.

Choice D reason: Urinary retention is not a typical finding in PKD. Instead, symptoms like hematuria (blood in the urine) and increased urinary frequency may occur.