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Nephrolithiasis Clinical Pathway – Emergency Department – Discharge Instructions for Ureteral Stone

Nephrolithiasis Clinical Pathway – Emergency Department

Discharge Instructions for Ureteral Stone

  • Provide urine strainer and instructions
  • Provide prescription for doxazosin or tamsulosin
    • Helps the ureter relax and stones pass
    • Side effects include orthostatic hypotension and dizziness
    • Continue until follow up appointment (3–4 wks) or until stone is passed
  • Age Medication Dosing Administration
    > 4 yrs Tamsulosin 0.4 mg once daily May open capsule and sprinkle in food
    ≤ 4 yrs Doxazosin 0.03 mg/kg once daily May crush tablet and mix into food
  • Review importance of hydration
  • Treat pain, provide prescriptions for:
    • Ibuprofen 10 mg/kg PO every 6 hrs, Max dose 600 mg
  • Urology within 3–4 wks
    • Will require repeat RBUS prior to office visit if renal pelvis/ureteral stone or secondary signs were present
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