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Renal Calculi Case Study Spring 2007

Mr. J, a 34-year-old male, presented to the emergency department with severe intermittent pain radiating from his left side to abdomen. CT scan revealed calcium oxalate crystals in his left kidney and urine tests confirmed hematuria. The diagnosis of renal calculi was made. He was prescribed medications to relieve pain, prevent further stone formation, and encourage fluid intake. He was discharged with follow up in two weeks.

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2K views

Renal Calculi Case Study Spring 2007

Mr. J, a 34-year-old male, presented to the emergency department with severe intermittent pain radiating from his left side to abdomen. CT scan revealed calcium oxalate crystals in his left kidney and urine tests confirmed hematuria. The diagnosis of renal calculi was made. He was prescribed medications to relieve pain, prevent further stone formation, and encourage fluid intake. He was discharged with follow up in two weeks.

Uploaded by

niting11
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Renal Calculi/Case study

MR. J is a 34-year-old male who arrives at the emergency department


(ED) of a busy urban hospital accompanied by his brother who drove
him..
He complains of unbearable intermittent pain that started one day ago,
while at work. He felt nauseated and was diaphoretic later that day. He
was unable to take fluids because the nausea would not subside. The
following day he observed that his urine was scant and the color was
pink-red. He went to work because the pain had decreased much.
While at work, he felt a pain that radiated from his left side to his
abdomen and it was severe for one minute. He informed his brother
who works nearby, and who also transported him to the ED.
Mr. J denies previous episodes of this type of pain and has no past or
current medication history.
His vital signs are within normal limits except for a temperature of 101
F degrees. Orders include:
Morphine sulfate 5 mg. sub.cut. stat
IV of D5.45% NS at 100ml/hr.
CT scan which shows calcium oxalate crystals in the left kidney calyx
Urine dipstick: positive for hematuria
Urinalysis reveals red blood cells (RBCs)
The urine has no odor or turbidity. The health care provider reviews
the laboratory data and diagnostic results, and a diagnosis of renal
calculi is confirmed. Mr. J’s denies further pain or nausea. He voids 100
ml. of dusky colored urine with trace of blood. The strained urine shows
one visible stone, and a sample is sent to the lab. for microscopic
analysis.
The following medications are prescribed:
Oxybutinin chloride (Ditropan) 5 mg PO two times per day, today only
Hydrochlorothiazide (HydroDIURIL) 50 mg PO two times per day.
Morphine sulfate (Astromorph PF, other trade names are Duramorph.
MS contin) 1-2 mg. IV q 1 -2 hr
IV D5.45% NS at 100 ml/hr. until 5 pm today
Encourage fluid intake of 2 -3 liters today
Accurate I & O, and strain all urine
Discharge after 5:00 pm with follow-up appointment in two weeks

What are the purposes for the prescribed orders?


What are the most common adverse reactions, drug -to -drug,
drug –to- food/herbal interactions of the prescribed medications?

Discuss other diagnostic tests used to identify urolithiasis

Discuss factors that contribute to urolithiasis

Discuss client education for urolithiasis

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