The nurse is caring for a client with multiple renal calculi. Which nursing interventions should be included in the plan of care? Select all that apply.

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The formation of renal calculi (ie, kidney stones) can be due to various factors (eg, family history, dietary imbalances, immobilization, dehydration). Manifestations include sudden, severe abdominal or flank pain and nausea/vomiting. Client management focuses on analgesics administered at regularly scheduled intervals, rehydration of up to 3 L/day unless contraindicated by other comorbidities, and ambulation to facilitate the passage of calculi (Options A and B). To retrieve stones that the client may pass, the nurse should strain all urine obtained (Option E). The collected stones are analyzed to determine their composition (eg, calcium oxalate, calcium phosphate, struvite, uric acid, cystine), which can then direct preventive measures, such as dietary and lifestyle changes, after discharge. (Option C) Immobilization is a contributing cause of renal calculi formation and should be avoided. Ambulation and frequent mobilization are encouraged as tolerated to help facilitate the passage of calculi. (Option D) Massage therapy to the flank should not be performed to prevent further instigation of renal colic. Other interventions, such as monitored heat therapy, would be acceptable. Educational objective: When caring for a client with renal calculi, the nurse should provide adequate analgesia for pain, encourage increased fluid intake, and assist with ambulation as tolerated to promote clearance of calculi. All urine should be strained to retrieve any stones for analysis to determine preventive measures.

The Nurse Is Caring for a Client with Multiple Renal