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Acute Pyelonephritis

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Acute Pyelonephritis
Andrea Gonzales
NUR351 NCLEX RN review Ms. Ashcraft
March 19, 2013

Definition Pyelonephritis is defined as inflammation of the renal parenchyma and the collecting system. It usually begins with an infection and colonization in the lower urinary tract through the ascending urethra. The types of patients at risk are patients who require frequent catheterization or the use of an indwelling catheter. This could potentially expose the patient to the different bacteria that are likely to cause pyelonephritis. Those bacteria types are E. coli, Proteus, Klebsiella, or Enterobacter. If the patient experiences recurrent episodes it can lead to the kidneys being scarred and becoming dysfunctional, it will have progressed from acute to chronic pyelonephritis. (Lewis, Ruff Dirksen, Mclean Heitkemper, Bucher, & Camera, 2011, pp. 1127,1128)

Assessment The patient is a 70 year old female who is a resident of a local nursing home. She has been complaining of unilateral flank pain, which she states gets more intense in the evenings. There at also been times when observed by staff at the nursing home when she seemed increasingly confused or disoriented. During the assessment she stated her flank pain was 8 out of 10, a fever was also noted at 38.9 degrees Celsius. As the assessment furthered she also stated that she has had a decrease of appetite and some GI discomfort. She stated this has been going on for about 4 days, she does require in and out catheterization which she performs herself.

Nursing Diagnosis
The patients nursing diagnosis is: Acute pain r/t inflammation of the urinary tract aeb patient states her pain level is a 8/10 and increases in the evenings. (Ackley, B.J. & Ladwig, G.B. 2011).

Plan Complete all ordered labs and diagnostics for confirmation of diagnosis. Administer all ordered medications such as antibiotics and opioid analgesics on time. Obtain a comfort level of pain from patient, assess the patient for a decrease in pain and monitor all vital signs, watch for signs and symptoms of urosepsis. Follow up and monitor all labs for a decreasing trend. Determine patient’s readiness for learning, and educate the patient on the proper technique when performing self-catheterization. (Ackley,2011).
Evaluate
I learned a lot about pyelonephritis when researching this paper, a lot that I didn’t include in the paper. I will now be able to teach, and educate people on preventing pyelonephritis as it very serious. There are probably many people who don’t know that this could turn into an organ, or life threatening problem and how it requires immediate treatment. I can’t wait to put all the skills and the knowledge I have obtained to good use to help my future patients.

References

Ackley, B.J., & Ladwig, G.B. (2011). Nursing diagnosis handbook: An evidence based guide to planning care (9th ed). St. Louis, MO: Mosby, Inc.
Lewis, S. L., Ruff Dirksen, S., Mclean Heitkemper, M., Bucher, L., & Camera, I. M. (2011). Medical Surgical Niursing. St. Lewis : Elsevier Mosby.…...

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