A client undergoes surgery to remove kidney stones, and a nephrostomy tube is inserted. Which intervention should the nurse include in the client's plan of care?

Nursing care for a client with a nephrostomy tube after surgery for kidney stones focuses on maintaining tube patency, preventing infection, and monitoring urinary drainage. A nephrostomy tube provides direct drainage of urine from the renal pelvis to an external collection system, bypassing the ureter. Because it creates a direct pathway from the kidney to the outside environment, infection prevention and site assessment are priorities. Early detection of complications such as infection or obstruction is essential to protect renal function. Rationale: A. Closely observing the arteriovenous fistula is incorrect because an AV fistula is used for hemodialysis access in clients with end-stage renal disease, not for nephrostomy tube care. This client has a urinary drainage device related to kidney stone removal, not a vascular access device. Therefore, this intervention is unrelated to the current clinical situation. B. Preparing for rapid blood transfusion and fluid replacement is not routinely required after nephrostomy tube insertion unless there is evidence of significant hemorrhage or hemodynamic instability. While bleeding can occur as a complication, it is not an expected routine intervention. Monitoring vital signs and urine output would be more appropriate for early detection of complications. C. Monitoring for pain and purulent drainage from the drain site is appropriate because these are signs of infection or local inflammation. The nephrostomy tube creates an entry point for pathogens, increasing the risk of urinary tract or renal infection. Early identification of redness, swelling, foul-smelling drainage, or increased pain allows for prompt intervention and prevention of systemic infection. D. Restricting fluid intake and potassium and protein is incorrect because adequate hydration is essential to maintain urine flow and prevent obstruction of the nephrostomy tube. Fluid restriction would increase the risk of clot formation and decreased urinary drainage. Dietary restrictions of potassium and protein are not routinely required unless there is underlying renal dysfunction unrelated to the current procedure.