A nurse is discussing the plan of care of a client who is 4 hr postoperative and has a urostomy with an assistive personnel. Which of the following statements should the nurse include in the discussion?

A urostomy is a surgically created urinary diversion that allows urine to drain through a stoma into an external collection pouch. In the immediate postoperative period, close monitoring is essential to ensure adequate urine output, stoma viability, and early detection of complications such as obstruction or bleeding. Nursing care focuses on maintaining hydration, monitoring renal function, and assessing the stoma’s color and drainage characteristics. Early postoperative surveillance is critical for patient safety and recovery. Rationale: A. “Expect the client’s urine to contain clots for the first 24 hours.” Although slight blood-tinged urine may be expected after surgery, visible clots are not an anticipated finding and may indicate bleeding or obstruction. The urine should gradually clear rather than contain increasing clot formation. Presence of clots would require immediate assessment and intervention. B. “Expect the stoma to appear pale until healing is complete.” A healthy urostomy stoma should be moist, pink to red, and viable, indicating adequate blood supply. A pale, dusky, or dark stoma suggests compromised perfusion and requires urgent evaluation. Continuous assessment of stoma color is essential in the postoperative period. C. “We need to check the client’s urine output every hour.” Frequent monitoring of urine output is essential after urostomy creation to assess kidney function and ensure patency of the urinary diversion. Hourly output measurement helps detect early complications such as obstruction, dehydration, or decreased renal perfusion. D. “We will keep the client’s fluid intake restricted until he is free of pain.” Adequate hydration is necessary to maintain urine flow, prevent mucus buildup, and reduce the risk of urinary tract obstruction. Restricting fluids can lead to dehydration and impaired kidney function. Pain is not an indication for fluid restriction in a postoperative urostomy client.