Follow-up from encounter 2 days ago. Review results of tests. 87-year-old female with right lower back/flank pain (described as dull, achy and does not go away), nausea, vomiting for 6 days Daughter is present. Medical history significant for renal stones, diverticulitis, and Alzheimer's dementia. Patient lives with daughter who reports blood tinged urine. Patient was seen in office earlier with similar symptoms blood in urine, pain. Increased tenderness in lower right flank area noted. Bladder mildly distended VS normal afebrile. Lab results reviewed creatinine is 1.48, BUN is 32, both elevated from baseline. Urine results show gross blood without signs of infection. Chest film clear. Right renal calculi3. Reviewed laboratory evaluation results and CT results. Treatment options discussed with daughter and patient. Admit orders written to include nephrologist consult. IVF (NS) started in office. EMS called, patient was transported to the hospital