1. The client/caregiver can define pyelonephritis.
   1. It is the inflammation of kidney tissue and may be acute or chronic.
   2. Chronic pyelonephritis may destroy kidney tissue permanently.
   3. It is caused by bacterial infection of the lower urinary tract.
2. The client/caregiver can list factors that may increase risk of pyelonephritis.
   1. Pregnancy
   2. Testing or surgery of urinary tract or use of catheters to drain urine
   3. Trauma to the kidney
   4. Urinary stasis or back flow
   5. Bladder infections
   6. Conditions such as prostate enlargement, structural defects of ureters, or kidney stones
   7. Neurogenic bladder
   8. Chronic health problems (diabetes, kidney disease, etc.)
3. The client/caregiver can recognize signs and symptoms.
   1. Back, side, or groin pain
   2. Nausea or vomiting
   3. Fatigue
   4. Pain or burning on urination
   5. Urgent, frequent urination
   6. A loss of appetite
   7. Cloudy, foul-smelling urine
   8. Fever
   9. Decreased urine output
   10. Pus or blood in urine
4. The client/caregiver can list measures to prevent or control pyelonephritis.
   1. Females should follow practices to prevent urinary tract infections.
      1. Keep perineal area clean and dry.
      2. Wear cotton underpants and wear nonrestrictive clothing.
      3. Wipe from front to back after bowel movement.
      4. Urinate before and after sexual intercourse.
   2. Report early symptoms of urinary tract infection for early treatment (burning, frequency, cloudy urine, fever, and flank pain).
   3. Drink fluids, up to 3000 ml per day.
   4. Avoid caffeinated beverages and alcohol.
   5. Empty bladder routinely avoiding bladder distention.
   6. Use self-monitoring urine test for bacteria.
   7. Take antibiotics until completed.
   8. Consume acid-forming foods (such as meat, fish, poultry, eggs, grains, cranberries, prunes, and plum) to prevent stone formation.
   9. Keep follow-up physician and laboratory appointments.
5. The client/caregiver is aware of possible complications.
   1. Chronic pyelonephritis
   2. Scarring of the kidneys
   3. Hypertension
   4. General bacterial infection (shock or sepsis)

Resources

American Foundation for Urologic Disease
www.afud.org

National Kidney and Urologic Diseases Information
Clearinghouse
E-mail: nkudic@info.niddk.nih.gov

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com