Acute Flank Pain Case Study; 33-year old patient with Flank pain (Renal Colic)(SOAP note Included)
actual 2026
- The nurse held the medication. The healthcare provider (HCP)
calls and instructs the nurse to discontinue the potassium chloride.
The HCP informs the nurse the client will need to start dialysis and
he will be coming in to discuss this with the client.
A Complication Occurs - One week after surgery, the client is
discharged home. Three days later, the client calls the transplant
office to speak to the nurse. The client complains of abdominal pain
that has become unbearable in the last couple of hours.
After the nurse completes the assessment, what findings are most
important to report to the healthcare provider (HCP) ? - Blood
pressure of 178/92 mmHg.
Blood pressure is elevated. Client may require additional diuretic or
antihypertensive therapy to get blood pressure to normal range.
Respiratory rate of 28 breaths per minute.
Normal respiratory rate is 12-20 breaths per minute. Client has
tachypnea and should be reported to the healthcare provider for
further evaluation.
Bibasilar crackles.
,Acute Flank Pain Case Study; 33-year old patient with Flank pain (Renal Colic)(SOAP note Included)
actual 2026
Client is experiencing fluid volume overload. Bibasilar crackles are a
manifestation of the fluid volume overload.
Edema
Edema is an abnormal finding and should be reported to the
physician.
Based on the client's symptoms, what should the nurse suspect? -
The client has uremia and may need to start dialysis.
Classic signs of uremia are nausea, vomiting, fatigue, weight loss,
anorexia, muscle cramps, pruritis, and a change in mental status.
Based on the nurse's assessment, which assessment data supports the
decision to administer pain medication as the first intervention? -
Pain rating of 6/10.
Pain was 2/10 prior to transport and is now 6/10. Client is
experiencing an increase in intensity of the pain.
Heart rate of 102 beats/minute.
Heart rate may elevate when acute pain is present
Blood pressure of 132/76 mmHg.
Blood pressure increased from baseline prior to transfer. May be
attributed to acute pain.
Based on these problems, which nursing intervention should be
included in the client's plan of care? - Encourage the client to ask
questions and discuss fears about diagnosis.
An open atmosphere that allows for discussion can decrease anxiety.
Facilitate discussions with family members about the prognosis and
the impact on lifestyle.
Case Outcome - The client's family member is able to share
frustration and anger with other family members. In the meantime,
, Acute Flank Pain Case Study; 33-year old patient with Flank pain (Renal Colic)(SOAP note Included)
actual 2026
the medical regimen of immunosuppressants is successful in
reversing the organ rejection, the client is discharged home with the
support of family and the home care nursing agency.
The client returns to the transplant clinic in one week for follow up.
The client expresses gratitude to have a new kidney. The client plans
to take good care of the kidney through careful management of the
diabetes and hypertension as well as taking the immunosuppression
medications every day as directed. The client verbalizes
understanding of the need to continue to follow up with the
transplant department and nephrologist.
Client Teaching: Dietary Management - The client is tolerating
dialysis and discharge is scheduled. The nurse completes discharge
teaching for the goal, "Client will manage diet effectively while
receiving hemodialysis three times a week."
Clinical Manifestation - The client'sdiagnostic tests support the
medical diagnosis of end-stage renal disease (ESRD). The client is
brought into the clinic to discuss laboratory results. The nurse
assesses the client on arrival to the clinic. In addition to the client's
report of fatigue, anorexia, dyspnea, and nocturia, the nurse's focused
assessment findings include: +3 pedal edema, basilar crackles in both
lungs, and clear, pale urine. The client's vital signs: temperature
98.8° F (37.1° C), heart rate 86 beats/minute, respirations 28
breaths/minute, and blood pressure 178/92 mmHg.
Diagnostic evaluation - The nurse contacts the healthcare provider
(HCP) regarding the client's symptoms. The HCP orders laboratory
testing.
The following diagnostic tests are performed and results are as
follows:
Hemoglobin: 7.8 g/dL (78 g/L)
Hematocrit: 30% (0.30 proportion of 1.0)
actual 2026
- The nurse held the medication. The healthcare provider (HCP)
calls and instructs the nurse to discontinue the potassium chloride.
The HCP informs the nurse the client will need to start dialysis and
he will be coming in to discuss this with the client.
A Complication Occurs - One week after surgery, the client is
discharged home. Three days later, the client calls the transplant
office to speak to the nurse. The client complains of abdominal pain
that has become unbearable in the last couple of hours.
After the nurse completes the assessment, what findings are most
important to report to the healthcare provider (HCP) ? - Blood
pressure of 178/92 mmHg.
Blood pressure is elevated. Client may require additional diuretic or
antihypertensive therapy to get blood pressure to normal range.
Respiratory rate of 28 breaths per minute.
Normal respiratory rate is 12-20 breaths per minute. Client has
tachypnea and should be reported to the healthcare provider for
further evaluation.
Bibasilar crackles.
,Acute Flank Pain Case Study; 33-year old patient with Flank pain (Renal Colic)(SOAP note Included)
actual 2026
Client is experiencing fluid volume overload. Bibasilar crackles are a
manifestation of the fluid volume overload.
Edema
Edema is an abnormal finding and should be reported to the
physician.
Based on the client's symptoms, what should the nurse suspect? -
The client has uremia and may need to start dialysis.
Classic signs of uremia are nausea, vomiting, fatigue, weight loss,
anorexia, muscle cramps, pruritis, and a change in mental status.
Based on the nurse's assessment, which assessment data supports the
decision to administer pain medication as the first intervention? -
Pain rating of 6/10.
Pain was 2/10 prior to transport and is now 6/10. Client is
experiencing an increase in intensity of the pain.
Heart rate of 102 beats/minute.
Heart rate may elevate when acute pain is present
Blood pressure of 132/76 mmHg.
Blood pressure increased from baseline prior to transfer. May be
attributed to acute pain.
Based on these problems, which nursing intervention should be
included in the client's plan of care? - Encourage the client to ask
questions and discuss fears about diagnosis.
An open atmosphere that allows for discussion can decrease anxiety.
Facilitate discussions with family members about the prognosis and
the impact on lifestyle.
Case Outcome - The client's family member is able to share
frustration and anger with other family members. In the meantime,
, Acute Flank Pain Case Study; 33-year old patient with Flank pain (Renal Colic)(SOAP note Included)
actual 2026
the medical regimen of immunosuppressants is successful in
reversing the organ rejection, the client is discharged home with the
support of family and the home care nursing agency.
The client returns to the transplant clinic in one week for follow up.
The client expresses gratitude to have a new kidney. The client plans
to take good care of the kidney through careful management of the
diabetes and hypertension as well as taking the immunosuppression
medications every day as directed. The client verbalizes
understanding of the need to continue to follow up with the
transplant department and nephrologist.
Client Teaching: Dietary Management - The client is tolerating
dialysis and discharge is scheduled. The nurse completes discharge
teaching for the goal, "Client will manage diet effectively while
receiving hemodialysis three times a week."
Clinical Manifestation - The client'sdiagnostic tests support the
medical diagnosis of end-stage renal disease (ESRD). The client is
brought into the clinic to discuss laboratory results. The nurse
assesses the client on arrival to the clinic. In addition to the client's
report of fatigue, anorexia, dyspnea, and nocturia, the nurse's focused
assessment findings include: +3 pedal edema, basilar crackles in both
lungs, and clear, pale urine. The client's vital signs: temperature
98.8° F (37.1° C), heart rate 86 beats/minute, respirations 28
breaths/minute, and blood pressure 178/92 mmHg.
Diagnostic evaluation - The nurse contacts the healthcare provider
(HCP) regarding the client's symptoms. The HCP orders laboratory
testing.
The following diagnostic tests are performed and results are as
follows:
Hemoglobin: 7.8 g/dL (78 g/L)
Hematocrit: 30% (0.30 proportion of 1.0)
