Problem
I. A patient with severe right flank pain, general weakness, and fever is hospitalized. The patient has a history of recurrent urinary tract infection and renal calculi are suspected. On the second hospital day, the patient's urine output decreases to 300ml/24 hours and the patient has distention and pain in the suprapubic area. The nurse would suspect which of the following to be the most likely cause for this sudden change?
i. Sudden decreased renal perfusion
ii. Inadequate fluid shift
iii. Interstitial fluid shift
iv. Urinary tract obstruction
II. The nurse is developing a discharge teaching plan for a patient who had a lithotripsy procedure (also called extracorporeal shock wave lithotripsy [ESWL]) for a large stone (about 7.5 mm in size). Since the patient will receive moderate sedation during the procedure, the teaching plan is presented to the patient before the procedure. Describe information the teaching plan should include? Include best approach to preventing kidney stones (no matter what type of stone it is, what is the best approach)?