Acute pyelonephritis is complex, and there is no consistent set of signs and symptoms that is both sensitive and specific for the diagnosis. Therefore, clinicians must maintain a high index of suspicion.
In contrast to the plethora of data available for the treatment of cystitis, less substantial data are available regarding the appropriate antibiotic choice or duration of therapy for acute pyelonephritis. An additional cause for concern is the growing resistance of uropathogens to standard agents. Nevertheless, useful recommendations can be made. (emedicine)
Nursing Care Plan for Pyelonephritis
Nursing Diagnosis for Pyelonephritis : Acute Pain related to inflammation and infection of the urethra, bladder and other urinary tract structures.
Evaluation criteria: no pain when urinating, no pain on percussion of the pelvis.
Nursing Interventions and Rational for Pyelonephritis
Independent
1. Monitor urine output to changes in color, odor and voiding pattern, input and output every 8 hours and monitor the results of repeated urinalysis.
Rational: To identify indications of progress or deviations from expected results.
2. Record the location, duration, intensity scale (1-10) the spread of pain.
Rational: To help evaluate the obstroksi and cause pain.
3. Provide comfort measures, such as back massage, environment, rest, sleep.
Rational: Increase relaxation, reduce muscle tension.
4. Help or encourage the use of focused relaxation breathing.
Rational: Helps to redirect attention and for muscle relaxation.
5. Give perianal care.
Rational: To prevent contamination of the urethra.
6. If mounted catheter, catheter care provided 2 times per day.
Rational: The catheter provides a way for bacteria to enter the bladder and up into the urinary tract.
Collaboration
1. Consul doctor if: previous urine yellow, ivory, yellow urine, dark orange, hazy or cloudy. Micturition pattern changes, frequent urination in small amounts, feeling the urge to urinate. Persistent pain or increasing pain.
Rational: These findings could signal further tissue damage and needs extensive examination.
2. Give analgesics as needed and evaluate its success.
Rational: Analgesic block the path of pain, thereby reducing pain.
3. Giving antibiotics. Create a variety of drink preparations, including fresh water. Provision of water to 2400 ml / day.
Rational: As a result of urine output makes it easy to urinate often and help flush urinary tract.
Source : http://careplannursing.blogspot.com/2012/01/acute-pain-nursing-care-plan-for_31.html
