Question

When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find: A. Cherry-red urine that gradually becomes clearer B. Orange-tinged urine containing particles of calculi C. Dark red urine that becomes cloudy in appearance D. Dark, smoky-colored urine with high specific gravity

Short answer

Answer: Orange-tinged urine containing particles of calculi.

Step-by-step solution

Understand extracorporeal lithotripsy

Extracorporeal lithotripsy is a non-invasive procedure to break down kidney stones and ureter stones using high-energy shock waves. The goal is to break the stones into smaller pieces, which can then pass through the urinary system more easily and be expelled naturally.

Assess possible urinary output options

Based on the understanding of extracorporeal lithotripsy, let's analyze each of the given options by comparing them to the likely outcomes of the procedure: A. Cherry-red urine that gradually becomes clearer: It is possible for the urine to initially have some blood as a result of the procedure, and then become clearer as the irritation subsides. B. Orange-tinged urine containing particles of calculi: Since lithotripsy aims to break down kidney stones into smaller fragments, it is logical to expect urine containing particles of broken stones, which might give the urine an orange tinge. C. Dark red urine that becomes cloudy in appearance: Dark red urine typically indicates old blood, and cloudy urine suggests infection or other factors not associated with extracorporeal lithotripsy. D. Dark, smoky-colored urine with high specific gravity: Dark, smoky-colored urine indicates a high concentration of red blood cells, which is not a typical outcome of extracorporeal lithotripsy.

Choose the correct urinary output

Based on the analysis of each option, Option B. Orange-tinged urine containing particles of calculi is the most plausible urinary output to be expected from a client who has had extracorporeal lithotripsy.

Key concepts

Extracorporeal Lithotripsy

Extracorporeal lithotripsy is a crucial medical procedure aimed at treating kidney stones. This non-invasive technique uses high-energy shock waves to break down kidney and ureter stones into smaller, manageable pieces. Once fragmented, these stones can more easily pass through the urinary tract without causing significant discomfort to the patient. The procedure is considered effective and safe, often performed on an outpatient basis, allowing patients to recover quickly. Lithotripsy is generally recommended when stones are too large to be passed naturally or cause significant pain or obstructions in the urinary tract.

Urinary Output Assessment

A crucial aspect of monitoring after an extracorporeal lithotripsy procedure is assessing the urinary output. This assessment helps healthcare professionals determine the success of the procedure and monitor the patient's recovery. Post-lithotripsy, urine may contain fragments of the broken stones, often visible to the naked eye. Some blood in the urine is common immediately after the procedure, eventually resolving as the healing process progresses. Nurses and healthcare providers are trained to observe changes in urine color and clarity, which can provide valuable information about the patient's condition and the effectiveness of the lithotripsy treatment.

Nursing Procedures

Nurses play a vital role in the care of patients undergoing extracorporeal lithotripsy. Before the procedure, they provide education and support, ensuring the patient understands what to expect. Post-treatment, nursing procedures include monitoring vital signs and urinary output to detect any complications early. Nurses also instruct patients on how to manage pain and encourage fluid intake to promote the passage of stone fragments. This comprehensive care aims to prevent complications, such as urinary tract infections, and enhance recovery. Nurses must document all findings accurately to ensure proper follow-up care and communication with the healthcare team.

Kidney Stones

Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. Factors such as dehydration, certain diets, obesity, and medical conditions can increase the risk of developing these stones. They may obstruct the urinary tract, leading to significant pain, infection, or even kidney damage. Treatment depends on the stone's size, location, and underlying causes, with smaller stones often treated by increased water intake and pain relievers. However, larger stones, which may not pass on their own, often require extracorporeal lithotripsy or other medical interventions to prevent complications and ease symptoms.

Patient Care

Patient care in the context of kidney stones and lithotripsy revolves around providing comprehensive assistance and information to ensure a smooth recovery. This involves educating the patient about lifestyle changes that can prevent future stone formation, such as maintaining proper hydration, dietary adjustments, and regular medical check-ups. It's also essential to manage expectations regarding the healing process and any potential side effects of treatments like lithotripsy. Building a trusting relationship and offering supportive care are fundamental in encouraging adherence to follow-up appointments and prescribed treatments, ultimately promoting long-term health and well-being.