Postpercutaneous lithotripsy, the nurse should instruct the client to:

• A. Limit oral fluid intake for 1 to 2 weeks
• B. Report the presence of fine, sand-like particles through the nephrostomy tube
• C. Notify the physician about cloudy or foul-smelling urine
• D. Report bright pink urine within 24 hours after the procedure

Answer: (C)

After percutaneous lithotripsy, the top priority is watching for infection in the urinary tract. Cloudy or foul-smelling urine suggests a urinary tract infection or possible sepsis and needs prompt evaluation by the healthcare team. Hydration is important after this procedure to help flush the urinary system, so limiting fluids isn’t advised. Some stone fragments passing through the nephrostomy tube can happen after lithotripsy, so seeing fine sand-like particles may occur but isn’t as urgent as signs of infection. Bright pink urine can be expected in the immediate postoperative period due to irritation and bleeding from the urinary tract, and it usually resolves gradually unless it becomes heavy or clotted. So reporting cloudy or foul-smelling urine is the most important instruction.