Pyelonephritis Pathology

Pyelonephritis 1 Running head: PYELONEPHRITIS

Pyelonephritis Elisabeth Fandrich Montana Tech Nursing Department NURS 1566 Core Concepts of Adult Nursing

April 7, 2008 Noel Mathis RN, BSN, MSN

Pyelonephritis

Pyelonephritis 2 Also known as a kidney infection, pyelonephritis is an infection of the kidneys. It is usually an ascending 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 the ureters or the pelvis of the kidney. Although cystitis (bladder infection) is common, the occurrence of pyelonephritis is seen less. The common signs and symptoms of pyelonephritis are flank pain, dysuria, abdominal pain that radiates 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, mental status changes, and foul smelling urine. 3511,L,B presented to the emergency department complaining of severe abdominal pain and mental status changes. A CT scan was done and it was determined that there was abnormal dilation of the left urinary collecting system with urine and air. It was also noted that there was extensive abnormal perinephretic fat stranding, and fluid along the spleen. These observations are indicative 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 high glucose, 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 bacteria was cultured. The patient had a high WBC level (12.67 K/uL), high % Neuts (93.8%), high absolute neuts (11.88 K/uL), low % Lymphs (2.5%) and low absolute lymphs (0.31 K/uL). This indicates acute infection rather than a chronic infection. With subsequent labs, these values have shown steady improvement. The most recent results show that the WBC count is within normal limits, the % Neuts are only slightly high. The % Lymphs are still low at 14.9%, but this value has improved quite a bit. The RBC, HGB and HCT have all fallen slightly below normal ranges in the

Pyelonephritis 3 last labs. This could be explained by the body’s response to the anti-infective agent given to kill the causative organism of the pyelonephritis. The treatment of pyelonephritis requires that a culture and sensitivity be done to determine the causative organism. Appropriate anti-infectives are then administered to the patient. Recovery from pyelonephritis is usually relatively quick after appropriate treatment.

Pyelonephritis 4

References

Pyelonephritis. (2008). Pyelonephritis. In Wikipedia [Web]. San Fransisco: Wikipedia Foundation. Retrieved April 7, 2008, from http://en.wikipedia.org/wiki/Pyelonephritis Charytan, MD, MSc, D (2006). Kidney infection (pyelonephritis). In MedlinePlus [Web]. Bethesda: U.S. National Library of Medicine. Retrieved April 7, 2008, from http://www.nlm.nih.gov/medlineplus/ency/article/000522.htm