A client is complaining of severe flank and abdominal pain. A flat plate of the abdomen shows urolithiasis. Which of the following interventions is important?
A. Strain all urine.
B. Limit fluid intake.
C. Enforce strict bed rest.
D. Encourage a high calcium diet.
Correct Answer: A. Strain all urine.
Urine should be strained for calculi and sent to the lab for analysis. Strain all urine. Document any stones expelled and sent to the laboratory for analysis. Retrieval of calculi allows identification of type of stone and influences choice of therapy.
Option B: Fluid intake of three (3) to four (4) L is encouraged to flush the urinary tract and prevent further calculi formation. Promote sufficient intake of fluids. Increased hydration flushes bacteria, blood, and debris and may facilitate stone passage. Offer fruit juices, particularly cranberry juice to help acidify urine.
Option C: Ambulation is encouraged to help pass the calculi through gravity. Encourage the patient to walk if possible to facilitate spontaneous passage. Determine patient’s normal voiding pattern and note variations. Calculi may cause nerve excitability, which causes sensations of an urgent need to void. Usually, frequency and urgency increase as calculus nears ureterovesical junctions.
Option D: A low-calcium diet is recommended to help prevent the formation of calcium calculi. Reduces risk of calcium stone formation. Note: Research suggests that restricting dietary calcium is not helpful in reducing calcium-stone formation, and researchers, although not advocating high-calcium diets, are urging that calcium limitation be reexamined.
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