A client with renal calculi is experiencing hematuria and reports severe flank pain.
Which intervention should the nurse implement first?
A.
Obtain a urine specimen for analysis.
B.
Administer a prescribed opioid analgesic.
C.
Strain the urine for the presence of stones.
D.
Prepare the client for a prescribed computed tomography (CT) scan.
E.
Prepare the client for a prescribed computed tomography (CT) scan.
The Correct Answer and Explanation is:
The correct answer is B. Administer a prescribed opioid analgesic.
Explanation:
In a client experiencing renal calculi (kidney stones), presenting symptoms often include severe flank pain and hematuria. The pain from renal calculi can be excruciating, and managing this pain is a priority in nursing care. Here’s a breakdown of why administering a prescribed opioid analgesic should be the first intervention:
- Pain Management Priority: Severe flank pain indicates that the client is likely experiencing renal colic, which is associated with kidney stones. The pain can be debilitating and may lead to complications such as increased heart rate, anxiety, and hypertension. Immediate pain relief is essential to provide comfort and stability to the patient.
- Safety and Comfort: Administering analgesics first allows the nurse to alleviate suffering, which is a fundamental aspect of nursing care. Effective pain control can help the client feel more secure and less anxious, allowing for better cooperation during subsequent assessments and interventions.
- Subsequent Interventions: While obtaining a urine specimen, straining for stones, and preparing for imaging (like a CT scan) are all important actions in the overall management of renal calculi, these should follow pain management. Once the client is more comfortable, the nurse can then focus on diagnostic tests and further assessments.
- Assessment Considerations: After administering the analgesic, the nurse should monitor the client’s response to the medication and any changes in vital signs or symptoms. This ensures that the client is stable before proceeding with further interventions.
In summary, while other interventions are crucial in managing renal calculi, pain relief must be prioritized to ensure the client’s immediate comfort and well-being. Thus, administering the prescribed opioid analgesic is the appropriate first step in this scenario.