Pyelonephritis concept map PDF

Preview

Summary

Download Pyelonephritis concept map PDF

Description

Disease: acute Pyelonephritis Etiology -

Inflammation of the renal parenchyma and collecting system(including renal pelvis) Most common cause is bacteria but can also be caused by fungus, protozoa, or virus Infection of the lower urinary tract via ascending ureteral route Commonly starts in the renal medulla and spreads to the adjacent cortex Bacteria found in GI tract frequently cause Preexisting factor often present such as vesicoureteral reflux (backward movement of urine) or dysfunction of lower urinary tract CAUTI Risk factors: pregnancy induced physiologic changes in urinary system Recurring pyelonephritis can lead to chronic pyelonephritis

Urosepsis: -

Systemic infection from urological source Can lea to septic chock then death Characterized by bacteriuria and bacteremia Prompt recognition and treatment of septic shock may prevent death

S/S: -

Mild fatigue Sudden onset of chills Fever Vomiting Malaise Flank pain Dysuria Urgency and frequency of urination Costovertebral tenderness to percussion Even without specific therapy, bacteria and pyuria usually persist

Labs: -

WBC casts in urine Leukocytosis in blood test with an increase in bands (immature neutrophils) Urine cultures must be obtained when pyelonephritis is suspected

DX studies:

-

Ultrasounds CT scan Urine analysis/culture Blood work

Interproessional care: -

Pt with mild symptoms treated din outpatient with antibiotics 14-21 day Parenteral antibiotics are often given initially in the hospital to rapidly establish high serum and urinary drug levels When pt is bale to tolerate fluids and oral antibiotics they are discharged on oral antibiotics for an additional 14-21 days Symptoms typically improve or resole within 48-72 hours after starting therapy Relapses treaded with a 6-week course of antibiotics Antibiotic prophylaxis may b used for recurring infections

Nursing assessment: 45-7 Similar to pt with UTI

Nursing implementation: -

Similar to tat of cystitis Early treatment to prevent systemic infections Pts with structural abnormalities are at high risk of infection and need regular medical care Pt continuing meds as prescribed Follow up urine culture Recognizing signs of recurrence Pt should drink at least 8 glasses of fluid every day even after infection has been treated Rest to increase comfort Makin sure pt understands treatment and reasons for it as well as importance to adherence to it

Chronic pyelonephritis: -

Kidney become small, atrophic and shrunken and lose function due to fibrosis Usually the result of a recurring upper urinary tract infect May happen without existing infection, recent infection, or UTI history

-

DX studies: Imaging: Reveals size and fibrosis

-

Biopsy: result indicate loss of malfunction nephrons, infiltration of parenchyma with inflammation, and fibrosis

Level of renal function depends on whether both or one kidney is effected, the extent of scarring, ad presence of coexisting infection Can progress to end stage renal disease...