Nephrolithiasis Quiz: Ace Your Exams

A 48-year-old woman presents to the emergency department for evaluation of right flank pain and hematuria that began suddenly that morning. The pain is intense and lasts for about 30 minutes before it resolves, and then it comes on again. She has no past medical history and is otherwise healthy. Temperature is 37°C (98.6°F), blood pressure is 156/65 mm Hg, heart rate is 88/min, respiratory rate is 14/min, and oxygen saturation is 98% on room air. On initial assessment, the patient appears uncomfortable and is vomiting into an emesis basin. On abdominal examination, there is mild distension and no abdominal tenderness, rebound, or guarding. There is right flank tenderness upon palpation. Urinalysis shows hematuria. The patient is started on IV normal saline and laboratory studies are pending. Point-of-care pregnancy screening is negative. Which of the following is the best next step in management?