Nursing Diagnosis for Pyelonephritis : Impaired Urinary Elimination


Pyelonephritis is an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney. It is a form of nephritis that is also referred to as pyelitis.

Pyelonephritis is a potentially serious kidney infection that can spread to the blood, causing severe illness. Fortunately, pyelonephritis is almost always curable with antibiotics.

Pyelonephritis presents with fever, accelerated heart rate, painful urination, abdominal pain radiating to the back, nausea, and tenderness at the costovertebral angle on the affected side.

Most cases of pyelonephritis are complications of common bladder infections. Bacteria enter the body from the skin around the urethra. They then travel up the urethra to the bladder.

Pyelonephritis may start with similar symptoms. However, once the infection has spread to the kidney, signs of more severe illness usually result:

  • Back pain or flank pain
  • Fever (usually present) and/or chills
  • Feeling sick (malaise)
  • Nausea and vomiting
  • Confusion (especially in the elderly)

Pyelonephritis may cause noticeable changes in the urine, such as:
  • Blood in the urine (hematuria)
  • Cloudy or foul-smelling urine
  • Pain when urinating
  • Increased frequency or urgency of urination

Nursing Diagnosis for Pyelonephritis : Impaired Urinary Elimination (dysuria, urge, frequency, and or nocturia) related to a kidney infection.

Goal : elimination pattern either

Expected Outcome : The pattern of elimination clients improved, there was no sign of urinary disorders (urgency, oliguric, dysuria)

Nursing Interventions and Rationale:

1. Measure and record the voiding of urine each time.
R /: To investigate the change of color, and to determine the input / output.

2. Advise to urinate every 2-3 hours.
R /: To prevent the buildup of urine in the urinary vesicles.

3. Palpation of the bladder every 4 hours.
R /: To determine the presence of bladder distension.

4. Help clients use bedpans / urinals.
R /: To facilitate clients in urination.

5. Help clients get a comfortable position to urinate.
R /: So that the client is not difficult to urinate.

6. Encourage increased fluid intake.
R /: Increased hydration rinse bacteria.

7. Observations of changes in mental status:, behavior or level of consciousness.
R /: Accumulated residual uremic and electrolyte imbalance can be toxic to the central nervous system.

Collaboration:

1. Perform laboratory tests; electrolytes, BUN, creatinine.
R /: Monitoring of renal dysfunction.

2. Take action to maintain acidic urine.
R /: Acid urine hinder the growth of germs.

3. Increase input berry juice and give medications to increase uric acid.
R /: Increased input juice can affect the treatment of urinary tract infections.

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