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Pyelonephritis, Holman, H. C., Williams, D., Johnson, J., Ball, B. S.,…
Pyelonephritis
Patient Education
maintain adequate nutritional status
drink plenty of water everyday
notify provider if any acute onset of pain or any fever
take rest periods as needed
take antibiotics as prescribed and dont stop taking even if you start feeling better
schedule a follow up and go to your appointment if indicated
Interventions
assess neuro status, I & O, fluid and electrolyes, and temp
increase fluid intake to 2 L per day
administer fever reducers as needed
meds
opioids for moderate to severe pain
antibiotics
procedures
pyeloithotomy - removal of large stone from kidneys
nephroectomy - removal of kidney when all proc. to clear infection were unsucessful
ureteroplasty - repair ureter
Pathophysiology
infection and inflammation of kidney pelvis, calyces, and medulla. Infection usually begins in the lower urinary tract and ascends into the kidney
e coli is a common cause
acute vs chronic
acute - active bacterial infection that occurs most frequently in females 20-30 years of age and can cause interstitial inflammation, tubular cell necrosis, abscess formation in capsule, cortex or medulla, temporarily altered kidney function
chronic - result of repeated infections that cause progressive inflammation and scarring
risk factors - males over 65 who have prostatitis and hypertrophy, chronic urinary stone disorders, pregnancy, bladder tumors, chronic illness, older adults and incomplete bladder emptying
Assessment
s/s - chills, abdominal pain, malaise, nausea, burning, urgency, and frequency, CVA tenderness, flank pain, fever, nocturia, hypertension, tachycardia, vomiting, tachypnea, or bacteriema
labs
UA and urine culture
WBC and differential
c reactive protein, ESR, creatinine and BUN
dx
x ray of kidneys, ureters, and bladder
ultrasonogrophy
gallium scan
IV pyelogram
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute
References:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing: Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5