Pyelonephritis 1Running head: PYELONEPHRITISPyelonephritisElisabeth FandrichMontana Tech Nursing Department NURS 1566 Core Concepts of Adult NursingApril 7, 2008 Noel Mathis RN, BSN, MSNPyelonephritis
Pyelonephritis 2Also known as a kidney infection, pyelonephritis is an infection of the kidneys. It is usually anascending infection, meaning that an infection of the lower urinary tract has reached the pelvis of the kidney. It occurs most often when there is a backflow of urine from the bladder into theureters or the pelvis of the kidney. Although cystitis (bladder infection) is common, theoccurrence of pyelonephritis is seen less.The common signs and symptoms of pyelonephritis are flank pain, dysuria, abdominal pain thatradiates around to the back on the affected side, fatigue, fever, nausea and vomiting, diaphoresis,urinary frequency, urinary urgency, nocturia, blood in the urine, cloudy or discolored urine, mentalstatus changes, and foul smelling urine.351
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,L,B presented to the emergency department complaining of severe abdominal pain andmental status changes. A CT scan was done and it was determined that there was abnormaldilation of the left urinary collecting system with urine and air. It was also noted that there wasextensive abnormal perinephretic fat stranding, and fluid along the spleen. These observations areindicative of pyelonephritis and also the possibility of a recently passed kidney stone.A urinalysis and labs were done upon admission. The urinalysis showed cloudy urine, with highglucose, ketones and protein as well as a positive clinitest. As the patient is diabetic, this indicates poorly managed blood sugars. There was also a large amount of blood in the urine and bacteriawas cultured. The patient had a high WBC level (12.67 K/uL), high % Neuts (93.8%), highabsolute neuts (11.88 K/uL), low % Lymphs (2.5%) and low absolute lymphs (0.31 K/uL). Thisindicates acute infection rather than a chronic infection. With subsequent labs, these values haveshown steady improvement. The most recent results show that the WBC count is within normallimits, the % Neuts are only slightly high. The % Lymphs are still low at 14.9%, but this value hasimproved quite a bit. The RBC, HGB and HCT have all fallen slightly below normal ranges in the
Pyelonephritis 3last labs. This could be explained by the body’s response to the anti-infective agent given to killthe causative organism of the pyelonephritis.The treatment of pyelonephritis requires that a culture and sensitivity be done to determine thecausative organism. Appropriate anti-infectives are then administered to the patient. Recoveryfrom pyelonephritis is usually relatively quick after appropriate treatment.
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Pyelonephritis Pathology
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