Question

Case Study 8 Name Class/Group Date Group Members INSTRUCTIONS: All questions apply to this case study. Your responses should be brief and to the point. Adequate space has been provided for answers. When asked to provide several answers, they should be listed in order of priority or significance. Do not asume information that is not provided. Please print or write clearly. If your response is not legible, it will be marked as ? and you will need to rewrite it. Scenario It is a hot summer day, and you are an RN in the ED. S.R., an 18-year-old woman, presents at the ED with severe L flank and abdominal pain, and NNVS.R.looks very tired, her skin is warm to touch, and she is porspiring. She paces about the room doubled-over and is clutching her abdomen. S.R. tells you that the pain started early this moming and has been pretty steady for the last 6 hours. She gives a history of working outside as a landscaper and takes little time for water breaks. Her PMH includes 3 kidney stone attacks, all during summer months. Exam findings: her abdomen is soft and without tendemess, but her L flank is extremely tender to touch palpation percussion. You place S.R. In one of the exam rooms and take the following VS: 188/98, 90. 20.990 F. Urinalysis shows RBC 50-100 on voided specimen, WBC zero. 1. It is very common for drug seekers to present with blood in their urine. What should you do to ensure the urinalysis is correct? 2. The MD orders an IVP (intravenous pylegram). What question do you need to ask S.R. before the test is conducted? 3. S.R. states she had an allergic reaction during her last IVP and was instructed "Don't let anyone give you dye for any testing." The MD cancels the IVP, what alternative test should be conducted? The abdominal CT scan shows a L 2 mm UVJ (ureteral vesicle junction) stono. 4. What are the two most common types of stones? 5. What is the most likely cause of S.R.'s stone?

Answer 1

me l. It should be made sure that patient is not menstruating 2. Ask about the posisility of fregnancy, allergy to iodine besed contrast dyes, any history of renal insuffriency 3. Ive with use of gadolinium dye can be performed ni % allergy to iodinated dye's or random GT scan may be performed. 4. Calcuum stones in the form of celium oxalete, Calium phosphate and mixed celium oxalate a phosphate 5. Most Likely cause of SR.'s store is dalyelration as it leeds to build up of minerals in arine She also doesn't drink much water. 6. . Shock wave lithot ripsy Ureteroscopy Scanned with CamScanner