ureterolithotomy question

[moomoo111]

Hello to all, I need help with this question that is in the back of my Med Surg nursing book. I have researched everywhere and can't find the answer. The answers are supposed to be on the CD with the book but it is nowhere to be found. I could really use some help in this. Here's the question with the four possible answers:

A patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes:

A: Encouraging the patient to drink fruit juices and milk.

B. Forcing fluids of at least 2 to 3 L/day after nausea has subsided.

C. Irrigating the nephrostomy tube with 10 ml of normal saline solution as needed.

D. Notifying the physician if nephrostomy tube drainage is more than 30 ml/hr.

The book does not say anything about irrigitating the nephrostomy tube or anything about tube drainage being abnormal or normal. I'm assuming A is incorrect because that is going to be a risk factor for another stone. Is 2 to 3L/day fluids not too much? I'm stumped on this one. Thanks for your help. No hurry on this one. I still have over a week before my exam and we didn't really talk about this in class so I'm assuming it won't be on the exam but I could be wrong. Beth:icon_roll

[Daytonite, BSN, RN]

A patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes:

A: Encouraging the patient to drink fruit juices and milk.

B. Forcing fluids of at least 2 to 3 L/day after nausea has subsided.

C. Irrigating the nephrostomy tube with 10 ml of normal saline solution as needed.

D. Notifying the physician if nephrostomy tube drainage is more than 30 ml/hr.

I believe the correct answer is "B".

You are correct about "A" and it makes no sense anyway. With a nephrostomy tube the patient needs to take 2 to 3 Liters of fluid in a day in order to maintain a nice flow of urine. "C" is outright wrong because you never irrigate a nephrostomy tube with more than 5mL of normal saline because the capacity of the renal pelvis (which is where the tip of the nephrostomy tube is located) is only 4 to 8mL maximum. And, since the tube is in the renal pelvis and draining the patient's urine, drainage of more than 30mL/hour would be ideal so there would be no need to notify the doctor of a normal situation, so "D" is eliminated as an answer.

[moomoo111]

Thank you for the help. I can see the way you used your critical thinking to solve that one. I did see after I posted the question that you wouldn't irrigate the tube so that pretty much narrowed it down. Thanks a bunch. Beth:cheers: