Reference no: EM133720607

Question

A 55-year-old female patient presented to the primary care office with a complaint of " flank pain" x 3 days. She reports dysuria, urinary frequency, urgency, fever (T.max of 101.5), and three vomiting episodes. She denies abdominal pain, dizziness, syncopal episodes, hematuria, or fatigue. She has been using AZO since her symptoms started because her best friend told her it would help. However, she has not received any relief. On presenting to the primary care office, vital signs are as follows: Temperature- 100.8, Respirations- 22, Pulse- 99, 02 saturations- 98%, pain level -8. The nurse practitioner obtained a medical history from the patient, who stated that she has a history of Nephrolithiasis. The patient also reports a family history of bladder cancer and Nephrolithiasis. The physical exam was unremarkable except for a positive costovertebral angle tenderness test on the left flank. The initial UA examination was positive for both nitrites, leukocytosis, and 3+ hematuria. The urine culture for this visit is pending; howver, the nurse practitioner reviewed the urine culture that was completed about three months ago which had a susceptibility to E.Coli. The nurse practitioner ordered a STAT non-contrast CT scan of the renal tract that revealed an obstructive.