A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take?

Choice A rationale Restricting protein intake is a dietary modification sometimes recommended to reduce purine metabolism, which can lead to uric acid stone formation in clients with urolithiasis. However, a general restriction to only two servings daily is excessively low and may lead to malnutrition, as it does not specify the type of stone and is not a universal primary care measure. Choice B rationale Applying a cold compress to the flank area can cause vasoconstriction, which may theoretically increase pain perception by reducing local blood flow and is generally contraindicated for renal colic. Heat application, such as a warm compress or warm bath, is typically more effective in promoting muscle relaxation and alleviating the acute flank pain associated with kidney stones. Choice C rationale Discouraging ambulation is counterproductive, as movement and ambulation are actively encouraged for clients with urolithiasis. Physical activity helps to promote the peristaltic movement of the ureters, which assists in the natural passage of small kidney stones, reducing the duration of symptomatic renal colic. Choice D rationale Encouraging a high fluid intake, specifically at least 3 L per day, is a critical nursing action for managing urolithiasis, regardless of stone type. Increased hydration helps to dilute the urine, which decreases the concentration of stone-forming crystals and increases the urinary volume to help flush the calculus through the urinary tract.