A client with renal calculi is preparing for discharge after an extracorporeal shock-wave lithotripsy (ESWL) removal. Which instruction should the nurse include in the client's postoperative discharge teaching?

A. Restrict physical activities: After extracorporeal shock-wave lithotripsy (ESWL), clients are generally encouraged to resume light activities and ambulation as tolerated. Movement actually helps facilitate the passage of fragmented kidney stones through the urinary tract. Strict activity restriction is usually unnecessary unless complications occur. B. Monitor urinary stream for decreased output: Following ESWL, stone fragments pass through the ureters and urethra in the urine. Clients must monitor their urinary output because obstruction by stone fragments can lead to decreased urine flow or urinary retention. Early recognition of reduced urinary output is important because it may indicate ureteral blockage or hydronephrosis, requiring prompt medical evaluation. C. Report when hematuria becomes pink tinged: Mild hematuria, including pink or slightly red urine, is expected for several days after ESWL due to irritation of the urinary tract from shock waves and passage of stone fragments. Clients are instructed to report persistent bright red bleeding, large clots, or worsening bleeding rather than mild pink discoloration. D. Use incentive spirometer: Incentive spirometry is commonly used after surgeries involving general anesthesia or procedures that increase the risk of postoperative pulmonary complications, such as abdominal or thoracic surgery. ESWL is a noninvasive procedure focused on the urinary tract and does not impair lung function, making routine use of incentive spirometer unnecessary.