Acute Pyelonephritis

Overall Goals

(1) normal renal function, (2) normal body temperature, (3) no complications, (4) relief of pain, (5) no recurrence of symptoms.

Interventions including teaching

(1) the need to continue medications as prescribed (2) the need to follow up urine culture to ensure proper management, (3) identification of risk for recurrence or relapse, (4) encourage adequate fluids.

Evaluation of Interventions

(1) use of non-analgesic relief measures, (2) appropriate use of analgesics, (3) passage of urine without urgency, (4) urine free of blood, (5) adequate intake of fluids.

Look at Chronic Pyelonephritis on pg 1129

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Objective Data

fever, hematuria, foul-smelling urine, tender and enlarged kidney, leukocytosis, positive findings for bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan, IVP.

Nursing Diagnosis

Acute Pain or Impaired urinary elimination.

Vesicoureteral Reflux

backward movement of urine from lower to upper urinary tract.

Common causes of Pyelonephritis and Urosepsis

catheterization, and the use of the indwelling catheters.

What bacteria causes pyelonephritis?

e. coli, proteus, klebsiella, enterobacter.

NSAIDS and antipyretic are given for what?

fever and discomfort.

Acute Pyelonephritis

inflammation of the renal parenchyma and collecting system.

Prophylaxis

may be used for recurrent infection.

Symptoms of Pyelonephritis

mild fatigue, chills, fever, vomitting, malaise(feeling of general discomfort), flank pain, and the LUTS charateristic of cystitis including dysuria, urinary urgency and frequency.

Complication factors

nausea and vomiting with dehydration require hospital admission.

Dysfunctions of lower urinary tract

obstruction from BPH, stricture(narrowing of the urethra), and urinary stone.

Casts

protein structures that are precipitated in the renal tubules. Presence of these in the urine indicates a pathologic condition of the kidney.

Urosepsis

systemic infection from urologic source. Quick diagnosis and effective treatment is critical because it can lead to septic shock and death.

Why are parenteral antibiotics given initially?

to rapidly establish high serum and urinary drug levels.

Tests that can be done

ultrasound, IVP, CT scan. Urine cultures must also be obtained and blood cultures are usually obtained as well.