a. Trauma to the kidneys includes contusions, lacerations, and rupture.

Because the kidneys are very vascular organs, receiving about one half the blood flow from the abdominal aorta, even a small laceration can cause massive hemorrhage.

b. Any blunt or penetrating injury to the back, flank, or abdomen may bruise, lacerate, or rupture a kidney.

c. Signs and symptoms of kidney trauma include:

(1) Nausea and vomiting.

(2) Back pain.

(3) Flank pain.

(4) Abdominal tenderness.

(5) Hematuria.

(6) Palpable mass (indicating internal bleeding).

(7) Shock.

d. Nursing implications.

(1) Treat shock and hemorrhage.

(2) Avoid administration of narcotic analgesics, as they mask symptoms that will indicate the onset of complications.

(3) Observe vital signs closely.

(4) Evaluate frequently for changes in status.

(5) Monitor hemoglobin and hematocrit for signs of internal bleeding.

(6) Maintain and monitor urinary drainage.

(7) Enforce strict bedrest.

(8) In cases of a severe or penetrating injury, surgical intervention is Prepare the patient for surgical repair or nephrectomy, as indicated.