Page 1861 - Saunders Comprehensive Review For NCLEX-RN

7. Signs of a UTI
8. Low-grade fever
9. High numbers of red blood cells, WBCs, and bacteria
noted in the urinalysis report
10. Gross hematuria

D. Interventions

1. Monitor vital signs, especially temperature, for signs
of infection.
2. Monitor intake and output.
3. Assess for fever, chills, and infection.
4. Monitor for nausea, vomiting, and diarrhea.
5. Encourage fluid intake up to 3000 mL/day, unless
contraindicated, to facilitate the passage of the stone
and prevent infection; monitor for obstruction.
6. Administer fluids intravenously as prescribed if
unable to take fluids orally or in adequate amounts to
increase the flow of urine and facilitate passage of the
stone.
7. Provide warm baths and heat to the flank area
(massage therapy should be avoided).
8. Administer analgesics at regularly scheduled intervals
as prescribed to relieve pain.
9. Assess the client’s response to pain medication.
10. Assist the client in performing relaxation techniques to
assist in relieving pain.
11. Encourage client ambulation, if stable, to promote the
passage of the stone.
12. Turn and reposition the immobilized client to promote
passage of the stone.
13. Instruct the client in the diet restrictions specific to the
stone composition if prescribed (Box 54-13).
14. Prepare the client for surgical procedures if prescribed.

For the client with renal calculi, strain all urine for the presence

of stones and send the stones to the laboratory for analysis.
XXI. Treatment Options for Renal Calculi (Fig. 54-6)
A. Cystoscopy
1. Cystoscopy may be done for stones in the bladder or
lower ureter.
2. One or two ureteral catheters are inserted past the
stone.
3. The catheters are left in place for 24 hours to drain the
urine trapped proximal to the stone and to dilate the
ureter.
4. A continuous chemical irrigation may be prescribed to

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