Acute Pyelonephritis Nursing Measures

Written by Zhou Qi
Nephrology
Updated on September 05, 2024
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Acute pyelonephritis, also known as an upper urinary tract infection, is a type of bacterial inflammation. In terms of care, patients should first focus on increasing their fluid intake. If the patient does not have urinary system stones, tumors, or other factors causing urinary obstruction—that is, if there is no kidney hydronephrosis—it is recommended that the patient's daily urine output be maintained at 2000-2500 milliliters. This means increasing fluid intake can help flush the urinary system, reducing bacterial growth and reproduction, which is beneficial for the treatment of pyelonephritis. Secondly, since the patient has acute inflammation, dietary considerations should include eating light, avoiding heavy and greasy foods as well as spicy and stimulating foods, and paying attention to perineal hygiene. Additionally, during episodes of fever, if the patient's body temperature is not very high, a warm water sponge bath can be given, especially focusing on the neck, armpits, and the root of the thighs, which can facilitate heat dissipation and is very beneficial for reducing body temperature.

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Written by Li Liu Sheng
Nephrology
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How is pyelonephritis treated?

Whether it is the treatment of acute pyelonephritis or chronic pyelonephritis, first of all, personal hygiene should be emphasized, physical fitness should be enhanced, water intake should be increased, and urination should be frequent. In addition, for patients with acute pyelonephritis, the main treatment is the use of sensitive antibiotics, which can be either semi-synthetic penicillin or cephalosporins, and fluoroquinolone antibiotics can also be used. For chronic pyelonephritis, if the patient has urinary anatomical or functional abnormalities, such as the presence of urinary stones or urinary obstruction, active surgical treatment can be considered to relieve the obstruction. Furthermore, patients with chronic pyelonephritis who also have hypertension and edema can appropriately use antihypertensive drugs and diuretics to control blood pressure and edema, which can play a role in protecting kidney function. (The use of medications should be conducted under the guidance of a doctor.)

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Written by Zhou Qi
Nephrology
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What foods to eat for pyelonephritis

Pyelonephritis is not nephritis, but a type of bacterial infection. Therefore, as a bacterial infection, there are no specific dietary restrictions for patients. Such patients should ensure adequate intake of fluids, with a recommended daily urine output of over 2000ml. This can help flush the urinary system and wash away some bacteria, reducing bacterial proliferation. Since it involves inflammation, it is advisable to follow a lighter diet, avoiding spicy, stimulating, and greasy foods, and focusing on easily digestible and warm foods.

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Written by Hu Lin
Nephrology
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How to treat acute pyelonephritis?

During the acute phase, it is important to rest, drink plenty of water, urinate frequently, and provide a diet that is easy to digest, high in calories, and rich in vitamins for patients with fever. For patients with evident bladder irritation symptoms and significant hematuria, oral sodium bicarbonate can be taken to alkalize the urine and relieve symptoms. The primary treatment for acute pyelonephritis, of course, is anti-infection therapy. The pathogen in 80% of acute pyelonephritis cases is Escherichia coli. After collecting urine samples for bacterial examination, treatment should be initiated. For patients with milder conditions, outpatient oral medication can suffice, with a treatment duration of 10 to 14 days. Common medications include ofloxacin, amoxicillin, and cephalosporins, among others. Secondly, for severe infections accompanied by obvious systemic toxic symptoms, hospitalization for intravenous medication is required. Commonly chosen drugs include ampicillin, cefotaxime sodium, ceftriaxone sodium, and levofloxacin, etc. If the patient improves following the above treatments, they can switch to oral therapy after fever cessation and continue with a drip for three more days to complete a two-week course of treatment. (Please use medications under the guidance of a doctor; do not self-medicate.)

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Written by Zhou Qi
Nephrology
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How to check for pyelonephritis?

Pyelonephritis, also known as upper urinary tract infection, is mostly caused by bacterial infection and the inflammatory response of the urinary system. The screening for this disease involves routine urine tests. Presence of white blood cells in the urine, coupled with symptoms like fever and back pain, can lead to a preliminary diagnosis. However, to confirm the diagnosis and identify the specific infecting pathogen, a culture of midstream urine is needed. Generally, to exclude certain causes of pyelonephritis, it is also necessary for the patient to have blood sugar levels checked and an ultrasound of the urinary system conducted. These tests can confirm whether the patient has diabetes, urinary system stones, or obstructions in the urinary system. Male patients can also undergo a prostate ultrasound to rule out urinary obstruction caused by prostate enlargement. These examinations can also help determine why the patient might have developed pyelonephritis.

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Written by Zhou Qi
Nephrology
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How to diagnose pyelonephritis?

For the diagnosis of pyelonephritis, it is first necessary to confirm the diagnosis. Generally, patients should first undergo routine urine tests. In these tests, the presence of white blood cells and positive nitrites, along with clinical symptoms such as back pain, blood in urine, and fever are common. A routine blood test often shows elevated white blood cells and C-reactive protein. These indicators together suggest the presence of pyelonephritis. Furthermore, a culture of a clean-catch midstream urine sample can be done. If the bacteria grow to a certain quantity, it can also help in confirming the diagnosis of pyelonephritis. Additionally, to assess complications associated with pyelonephritis, it is necessary to perform blood tests for kidney function and an ultrasound of the urinary system to rule out conditions such as acute renal failure, renal papillary necrosis, and perinephric abscess, among others.