The wife of a 42-year-old man called the office stating that within the last hour her husband had a sudden onset of seve
Posted: Tue Jul 05, 2022 8:50 am
The wife of a 42-year-old man called the office stating thatwithin the last hour her husband had a sudden onset of severe painin his left side and back. He has also experienced nausea andvomiting. Questioning revealed the pain to be in the left flankarea and quite severe. She also advised that the pain radiated downtoward the pelvis and that he was experiencing pressure in theperineal area and the frequent urge to urinate. A renal calculuswas suggested, and the patient's wife was advised to transport himto an emergency facility.Vital signs were the following: temperature, 99.6° F; pulse, 96;respiration, 20; and blood pressure, 124/88 mm Hg. A urine specimenwas obtained, and the dipstick indicated blood in the urine. Theabdomen was slightly distended, the left flank area exhibitedtenderness on palpation, and tenderness was noted over the bladder.A renal calculus was suggested. A kidney, ureter, and bladder (KUB)radiograph, an intravenous pyelogram (IVP), and an ultrasound ofthe kidneys were ordered. An intravenous (IV) line was started, andthe patient was given 2 mg of morphine sulfate IV push.The KUB revealed a suspicious area, 8 cm distal to the origin ofthe left ureter. The IVP confirmed the presence of a 3.5 mmcalculus distal to the ureteral origin. The renal ultrasoundindicated hydronephrosis of the left kidney. The patient wasadmitted for observation and for pain management.
1. What causes renal calculi to form?2. Why would patients’ symptoms vary?3. What would be the significant symptom or symptoms leading to thesuspicion of renal calculi?4. What is renal colic?5. What would cause blood in the urine?6. What is the cause of hydronephrosis?7. Why would the patient be instructed to strain all urine?8. What are the treatment options for the patient with renalcalculi?9. Why would IV morphine be given?
1. What causes renal calculi to form?2. Why would patients’ symptoms vary?3. What would be the significant symptom or symptoms leading to thesuspicion of renal calculi?4. What is renal colic?5. What would cause blood in the urine?6. What is the cause of hydronephrosis?7. Why would the patient be instructed to strain all urine?8. What are the treatment options for the patient with renalcalculi?9. Why would IV morphine be given?