S B A R

SBAR 73

S.R

Scenario

You are a registered nurse

in the emergency department (ED). It is a hot summer day

and S.R., a 25

-

year

-

old woman, comes to the ED with severe left flank and abdominal pain and

nausea with vomiting. S.R. looks very tired, her skin is warm, and she is perspiring. She paces

about the

room doubled over and is clutching her abdomen. S.R. tells you the pain started early

this morning and has been pretty steady for the past 6 hours. She gives a history of working

outside as a landscaper and takes little time for water breaks. Her past medi

cal history includes

three kidney stone attacks, all occurring during late summer. Her abdomen is soft and without

tenderness, but her left flank is extremely tender to touch. You place S.R. in one of the

examination rooms and take the following vital sign

s: 188/98, 90, 20, 99° F (37.2° C). A voided

urinalysis shows RBCs of 50 to 100 on voided specimen and WBCs of zero

CASE STUDY PROGRESS

The noncontrast CT scan shows a left 2

-

mm ureteral vesicle

junction stone

CASE STUDY PROGRESSS.R. was discharged with instr

uctions to strain all urine and return if

she experienced pain unrelieved by the pain medication or increased nausea and vomiting

CASE STUDY PROGRESSS.R. returns to the ED in 6 hours with pain unrelieved by the pain

medication and increased blood in her uri

ne. She is being held in the ED until she can be

transported to surgery.

CASE STUDY PROGRESSA 2

-

mm calculus was removed by basket extraction. Pathologic

examination reported the stone to be calcium oxalate.

CASE STUDY OUTCOMES.R. recovers from this most recent epis

ode and continues to follow

the protocol for fluid intake and dietary measures. One year later, she has yet to report a

recurrence of stones

SBAR 73 S.R

Scenario You are a registered nurse in the emergency department (ED). It is a hot summer day

and S.R., a 25-year-old woman, comes to the ED with severe left flank and abdominal pain and

nausea with vomiting. S.R. looks very tired, her skin is warm, and she is perspiring. She paces

about the room doubled over and is clutching her abdomen. S.R. tells you the pain started early

this morning and has been pretty steady for the past 6 hours. She gives a history of working

outside as a landscaper and takes little time for water breaks. Her past medical history includes

three kidney stone attacks, all occurring during late summer. Her abdomen is soft and without

tenderness, but her left flank is extremely tender to touch. You place S.R. in one of the

examination rooms and take the following vital signs: 188/98, 90, 20, 99° F (37.2° C). A voided

urinalysis shows RBCs of 50 to 100 on voided specimen and WBCs of zero

CASE STUDY PROGRESS The noncontrast CT scan shows a left 2-mm ureteral vesicle

junction stone

CASE STUDY PROGRESSS.R. was discharged with instructions to strain all urine and return if

she experienced pain unrelieved by the pain medication or increased nausea and vomiting

CASE STUDY PROGRESSS.R. returns to the ED in 6 hours with pain unrelieved by the pain

medication and increased blood in her urine. She is being held in the ED until she can be

transported to surgery.

CASE STUDY PROGRESSA 2-mm calculus was removed by basket extraction. Pathologic

examination reported the stone to be calcium oxalate.

CASE STUDY OUTCOMES.R. recovers from this most recent episode and continues to follow

the protocol for fluid intake and dietary measures. One year later, she has yet to report a

recurrence of stones