If a client with urolithiasis shows signs of urinary obstruction, what should the nurse instruct the client to do immediately?

The most appropriate action for the nurse to instruct the client who shows signs of urinary obstruction due to urolithiasis is to call the healthcare provider immediately. This is critical because urinary obstruction can lead to serious complications such as hydronephrosis, kidney damage, and severe pain. Timely intervention by a healthcare provider is essential to evaluate the situation, potentially perform imaging studies, and decide on the necessary treatments, which may include surgical intervention or other medical management.

While drinking water may seem beneficial for encouraging urination and passing stones, it is not advisable if there is a significant obstruction, as this could exacerbate discomfort or lead to worsening retention of urine. Self-catheterization could pose risks, especially if the client lacks proper training or if there are anatomical considerations due to the obstruction. Checking the pH of urine might provide some information, but it is not an immediate priority in the context of an acute situation requiring professional medical assessment. Thus, calling the healthcare provider is the most appropriate and immediate action to ensure the client receives the proper evaluation and care.