The nurse is caring for a patient who underwent lithotripsy for kidney stones earlier in the day. What instruction should the nurse give the patient?

Choice A reason: Limiting fluids is contraindicated after lithotripsy. Patients are encouraged to increase oral fluid intake to at least 2 to 3 liters per day to help flush out the stone fragments and prevent the formation of new calculi within the renal pelvis or ureters. Choice B reason: The presence of fine, sand-like particles is an expected and desired outcome of lithotripsy. This "stone sand" indicates that the shock waves successfully fragmented the large calculi into smaller pieces that can now pass through the urinary tract. It does not need to be reported as an adverse event. Choice C reason: Cloudy or foul-smelling urine is a clinical indicator of a urinary tract infection (UTI) or urosepsis. Because the fragmentation of stones can release trapped bacteria into the urinary system, the nurse must instruct the patient to monitor for these signs and report them to ensure prompt antibiotic treatment. Choice D reason: Pink-tinged urine (hematuria) is expected for the first 24 to 48 hours following a lithotripsy procedure due to the trauma caused by the shock waves and the passage of stone fragments. It is not considered an emergency unless the bleeding is bright red or contains large clots.