Pyelonephritis is an ascending urinary tract infection. The infection reaches the pyelum (pelvis) of the kidneys. If the infection becomes severe, the term urosepsis can be used interchangeably. Pyelonephritis require antibiotic as therapy and the treatment of underlying causes to prevent it from occurring again.
Pathophysiology of Pyelonephritis
Pyelonephritis most often occur in children with vesicoureteral reflux, pregnant women, and people who experience lower urinary tract infection. The infection then ascend causing the inflammation of the renal pelvis. It in turn produces edema of renal pelvis.
Signs and Symptoms of Pyelonephritis
- Flank pain
- High fever with chills
- Positive kidney punch (Costovertebral angle tenderness)
- Frequency in urination
- Urgency
- Dysuria
- Hematuria
Diagnostic Exam for Pyelonephritis
- Urinalysis presents with an increase in white blood cell count
- Urine culture
- Kidney, Ureter, Bladder Ultrasound
Management for Pyelonephritis
- Urinary antibiotics
- Nitrofurantoin – Given with meals, Rinse mouth to prevent from staining.
- Trimethoprim-Sulfamethoxazole, Co-trimoxazole (Bactrim) – Given with meals.
- Administer sulfonamides as ordered.
- Administer urinary analgesic, Phenazopyridine (Pyridium). Medication discolors the urine into orange or red.
- Increase oral fluid intake.
- Decrease protein diet.
- Acid ASH Diet.
Nursing Diagnosis for Pyelonephritis
Acute Pain
Nursing Care Management:- Apply warm moist packs.
- Provide a warm Sitz bath.
- Balance rest and activity.
- Administer analgesic as ordered.
