A nurse is planning care for a client who has renal stones and a urinary catheter in place. Which of the following interventions should the nurse include in the plan of care?

Choice A rationale Limiting fluid intake to 1500 mL/day is contraindicated for a client with renal stones. Adequate hydration, generally 2000 to 3000 mL/day, is essential to promote diuresis and the flushing of the renal calculi through the urinary system. Insufficient fluid volume increases urine concentration, which fosters the crystallization and aggregation of stone-forming solutes, thereby worsening the condition and risk of obstruction. Choice B rationale Straining the urine, even with a catheter in place, is a critical intervention to capture and retrieve any passed renal calculi fragments. These fragments must be sent to the laboratory for chemical composition analysis, which guides targeted preventive dietary and pharmacological therapy. Identifying the stone type (e.g., calcium, struvite, uric acid) is fundamental for effective secondary prevention of recurrence. Choice C rationale Clamping the urinary catheter periodically is a technique used to promote bladder muscle tone retraining, which is not indicated for a client with acute renal stones. Furthermore, clamping the catheter increases the risk of urinary stasis, promoting bacterial proliferation and reflux of urine back into the kidneys, significantly elevating the risk of pyelonephritis and sepsis. Choice D rationale Maintaining a client with renal stones on bed rest is not generally recommended and can be detrimental. Ambulation and mobility are encouraged as they promote the peristaltic movement of the ureters, which assists in the gravitational passage of the stone fragments. Prolonged immobility also increases the risk of bone demineralization, potentially contributing to calcium-based stone formation. 80mm.5pt.