NREMT Paramedic Cognitive ExamMedicalEasy
A 45-year-old male presents with acute onset of severe, colicky right flank pain radiating to his groin. He is restless, diaphoretic, and reports nausea. His vital signs are stable. He denies fever or dysuria. What is the MOST appropriate initial management?
- ATransport to a hospital capable of surgical lithotripsy.
- BAdminister intravenous fluids for hydration.
- CAdminister opioid analgesia.
- DEncourage oral fluid intake.
Show answer & explanationAnswer & explanation
Correct answer: C. Administer opioid analgesia.
This patient's presentation is classic for renal colic due to nephrolithiasis (kidney stones). The pain is typically excruciating and colicky. While hydration is supportive, the priority is pain management to alleviate distress. Opioid analgesia is often necessary due to the severity of the pain.
Why the other options are wrong
- A. Transport is necessary, but providing pain relief on scene or en route is a critical initial management step to improve patient comfort.
- B. IV fluids are supportive but not the primary initial intervention for severe pain, especially with stable vital signs.
- D. Encouraging oral fluids might be helpful later, but not while the patient is nauseated and in severe pain, and it won't alleviate the acute pain.
Renal Colic Management
Renal colic, caused by kidney stones, presents with severe, acute flank pain. Initial management focuses on effective pain control, often with opioids or NSAIDs, and supportive care.
- Pain is typically excruciating and colicky.
- Pain relief is the immediate priority.
- Hydration and antiemetics are supportive measures.
Memory trick: Stone pain is intense, give meds first!