What should nursing care focus on when caring for a patient with a ureteral catheter in place after the removal of a kidney stone?

Choice A rationale Early ambulation is generally encouraged for postoperative patients to prevent complications like deep vein thrombosis or atelectasis. However, for a patient with a ureteral catheter, the immediate risk is catheter displacement or kinking during movement. While mobility is good for bowel function, it is not the primary focus compared to ensuring the specific drainage system remains functional. Frequent assessment of the tubing during any movement is necessary to prevent internal trauma to the ureter. Choice B rationale Maintaining patency is the highest priority because the ureter is narrow and easily obstructed by edema or small stone fragments. Ureteral output must be monitored separately from bladder output to ensure the kidney is draining effectively. Normal adult urine output is 0.5 to 1.5 mL per kg per hour. If the catheter becomes blocked, hydronephrosis and intense pain can occur rapidly. Monitoring helps distinguish between renal production and bladder storage during recovery. Choice C rationale Irrigating a ureteral catheter is rarely done and never performed without a specific physician order. The renal pelvis has a very small capacity, typically only 3 to 5 mL. Forceful irrigation can cause significant pressure, leading to tissue damage, infection, or rupture of the ureteral wall. If irrigation is ordered, it must be done using sterile technique with extremely small volumes to avoid distending the kidney. Regular irrigation is not a standard nursing focus. Choice D rationale Restricting fluid intake is contraindicated because high fluid volume is needed to flush out residual stone fragments, blood clots, and bacteria. Maintaining a high urine flow rate helps keep the catheter patent and prevents the formation of new crystals or stones. Patients should generally aim for an intake that maintains a urine output of at least 2 liters per day. Restricting fluids increases the risk of urinary tract infections and catheter encrustation or blockage.