A 68-year-old man with diabetes presented to the emergency department with severe right flank abdominal pain and nausea. A urinalysis showed hematuria and an intravenous pyelogram confirmed a staghorn kidney stone in the right renal pelvis. The man reported poor sleep, little food intake, and fatigue.

1. Frank Fargo is a 68-year-old male with type 2 DM presented at the ED with severe R flank
ahdominal pain. and NI. The abdomen is soft and without tenderness. The right flank is
extremely tender to touch and palpation. B5 are BP. "42:3D. HR 88 bpm, RR 20,T 99. 0 F , A
urinalysis shows hematuria. IV initiation is established and 99 NS is to he infioed at a rure of 125
mlh . An intravenous pyelogram confirms the diagnosis of staghom-type stone in the R renal
pehte. The right kidney looks enlarged. Frank states that he did nor sleep well last might and has
nof caten much soday. He is othrosoty wery fatigued.