Urinary Calculi

Assignment:

Urinary Calculi

Write a 1000-1250 word paper addressing each of the following case study questions. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) sources in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

E.G. is a 41-year-old male who presents to the emergency department complaining of severe right back pain that started a couple of hours ago, right after he finished his daily run. He has a history of gastroesophageal

reflux disease, for which he takes famotidine 20 mg PO once daily at bedtime.

Subjective Data

Has been training for a marathon and has been running at least 10 miles a day, but today was so hot that he only made it 6 miles. Shortly after his run, the pain in his right back/side started.

• States his pain is a level 9 on a 1-to-10 scale
• States the pain is constant, nothing seems to make it better, and it does not get worse with movement
• Denies any pain or numbness in his legs

While training, he has been supplementing his diet with protein shakes

• Denies using performance-enhancing drugs

Objective Data

Physical Examination

• Temperature 99.6° F, pulse 78, respirations 16, blood pressure 122/80
• No musculoskeletal pain or tenderness in spine
• Right flank tenderness to fist percussion

Case Study Progress

Based on the initial clinical manifestations and exam findings, the health care provider orders a urinalysis. At first, E.G. is unable to urinate, but after drinking several glasses of water, is able to obtain a clean-catch urine

specimen.

Diagnostic Studies

Urinalysis:

Color: Dark, smoky color

Odor: Aromatic

Protein: None

Glucose: None

Ketones: None

Bilirubin: None

Specific gravity: 1.035

pH: 6.2

RBCs: 11/hpf

WBCs: 3/hpf

Casts: None

1. Based on the data above, what do you suspect is occurring with E.G.? What assessment data led you to this conclusion?
2. What additional test(s) may be ordered to confirm this diagnosis?
3. E.G. has an ultrasound, and the presence of a large right renal calculus is confirmed.

The health care provider orders E.G. IV Morphine sulfate for pain and recommends that he have a right extracorporeal shock-wave

lithotripsy (ESWL). Explain this procedure.

1. What factors put E.G. at risk for developing a renal calculus?
2. What teaching should E.G. receive prior to his being discharged?
3. What nutritional instructions should E.G. be given to prevent recurrence of urinary calculi?

Assignment Expectations

Length: 1000 – 1250 words; answers must thoroughly address the questions in a clear, concise manner.

Structure: Include a title page and reference page in APA style. These do not count towards the minimum word amount for this assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer

the questions. Include at least three (3) scholarly sources to support your claims.