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Pyelonephritis in Pregnancy - Coggle Diagram
Pyelonephritis in Pregnancy
pathological
Acute pyelonephritis is caused by a common bacteria, E-col, found in human feces.It enters the ureter, starting with the contamination around the urethra through the bladder upward. As the ureter goes into the renal cone, the germs will multiply and multiply, causing the disease to occur in pregnant women.
2% of acute nephritis is found in pregnant women. It is more common in the second trimester. Pregnant and often found that the right renal cone is more inflamed than the left renal cone. (dextrorotation) depresses the ureter, causing more urinary congestion in the right kidney, causing more inflammation and 25% of the ureteral cones were found. Each 40 has had an infection of the lower urinary tract before, and if treated poorly, it can cause septic shock.
Signs and symptoms
High fever, chills, as germs generate toxins (endotoxin) to stimulate the body to regulate temperature fluctuations, the temperature fluctuates between 34-40 c as the pathogens produce toxins. Stimulate the body to regulate temperature fluctuations, the Buddhist landscape is divided between 34 and 40 degrees Celsia with headache, fatigue, loss of appetite, nausea, vomiting, muscle aches
Have abdominal pain, lower back pain, or Both sides have dull pain when tapping the area between the rib cage and the spine. (costovertebral angle) is very painful, along with this area will be found to have stiffness, swelling, together with.
Symptoms of urination, burning, cloudy urine, if there is a lot of symptoms, urine may be pus.
In some cases, toxins. harmful to the alveoli, the efficiency of pulmonary edema, and adult respiratory distress syndrome, resulting in hemolysis of red blood cells. Acute anemia, low platelet count, is a symptom of sepsis and 15% of patients die from bacterial infection in the bloodstream (bacteremia) and septic shock.
Diagnosis
From the signs and symptoms, especially the knock, pain in the lumbar region, which is the position of the kidneys.
Urine delivery, will be found with a large number of white blood cells in the same way and stick together in a raft called white blood cell cast or Leukocyte cast and if urine is transmitted to cultivate the disease, she will find the disease.
Blood delivery will find a very high white blood cell count.
Ultrasound or X-ray examination.
Treatment
Treatment when shown should see a doctor within 24 hours to prevent severe symptoms and may have complications. Generally, doctors are often admitted in the hospital and treated as follows:
Drug to reduce fever and IV. In patients with nausea, vomiting and inability to eat
Antibiotics to eliminate common pathogens such as ciprofloxacin, ofloxacin, coamoxiclave, cortrimoxazole for 14 days
In severe cases and inability to eat, the doctor will administer intravenous antibiotics, including: gentamicin or cephalosporin Until symptoms improve, then change the drug to oral. But before drug administration, if But before the drug is given, the doctor will check the kidney function as well,
Effects of Disease on Pregnancy
Maternal Effects:
High blood pressure during pregnancy
Anemia increases higher than normal.
Effects on infants:
The baby grows slow in the womb. (intrauterine growth retardation)
preterm labor
perinatal death
Nursing Care
Care for pregnant women receive intravenous antibiotics at the correct size and time according to the treatment plan.
2.Care for receive water and mineral salts intravenously so that the urine output is not less than 30 ml / hr
Urine and blood collection according to sterile technique for transmission and the doctor will have a plan for CBC examination. , Creatinine and electrolyte.
Vital signs and urine output, especially in the first 24-48 hours, if the fever decreases, antibiotics can be taken for another 14 days and an appointment for a urine infection test 1-2 weeks after. Complete medication and if treatment is 48 to 72 hours and symptoms do not improve, urinary tract stones, gonorrhea, etc. must be thought of.
In the event that pregnant woman has a fever, she needs to wipe her body to reduce fever. According to the treatment plan, it also makes the patient feel refreshed and comfortable.
It is recommended to drink a lot of water 3000 ml per day to generate more urine, reduce the concentration of pathogens in the urine, stimulate urination more frequently. Finally By expelling the infection through urine and reducing fever as well.
Suggest to urinate every time when urinating symptoms do not urinate because it will cause the infection longer.
Get enough rest by providing a well-ventilated environment. Adequate rest will strengthen the body and have better resistance to illness.
Keep the body clean and dry, especially the external genitalia, after urination and feces. By wiping from front to back to reduce the chance of contamination of pathogens from the rectum into the urethra.
Record the intravenous fluid according to the treatment plan and record the amount, color, nature of urine to assess the condition of ureter After treatment.
Assess the condition of the fetus by listening to the fetal heart sounds every 4 hours, with the heart rate between 120 -160 beats / min and beating regularly.
If the pregnant woman is near the end of her pregnancy, the uterine contraction and fetal flexion should be assessed, as well as the actual pain of the pregnancy, to plan the care.
If your doctor allows you to go home, the nurse must give you important advice on how to act, especially antibiotic intake, blood tonic.
นางสาววรดา ภูสีดวง 601410030-7 SN.4