Activity Up ad lib

6. Nursing: Strain urine, measure inputs and outputs. Place Foley if no urine for 4 hours.

7. Diet: Regular, push oral fluids.

8. IV Fluids: IV D5 / NS at 100-125 cc/hr (maintain urine output of 80 mL/h).

9. Special Medications: -Cefazolin (Ancef) 1-2 gm IV q8h

-Meperidine (Demerol) 75-100 mg and hydroxyzine 25 mg IM/IV q2-4h prn pain OR

-Butorphanol (Stadol) 0.5-2 mg IV q3-4h.

-Hydrocodone/acetaminophen (Vicodin), 1-2 tab q4-6h PO prn pain OR -Hydromorphone (Dilaudid) 1-2 tabs q4-6h PO prn pain OR -Acetaminophen with codeine (Tylenol 3) 1-2 tabs PO q3-4h prn pain. -Ketorolac (Toradol) 10 mg PO q4-6h prn pain, or 30-60 mg IV/IM then 15-30

mg IV/IM q6h (max 5 days). -Zolpidem (Ambien) 10 mg PO qhs prn insomnia. Note: If stone <5 mm without sepsis then discharge home with analgesics and increase PO fluids. If stone >10 mm and/or fever or increased WBC or signs of ureteral dilation, admission for urology evaluation is indicated.

11. Extras: Intravenous pyelogram, KUB, CXR, ECG.

12. Labs: CBC, SMA 6 and 12, calcium, uric acid, phosphorous, UA with micro, urine C&S, urine pH, INR/PTT. Urine cystine (nitroprusside test), send stones for X-ray crystallography. 24 hour urine collection for uric acid, calcium, creatinine.

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