CPD practice profile
Pyelonephritis Acute pyelonephritis refers to a lower urinary tract infection that has spread to the pelvis of the kidney. An estimated one in 830 people in the UK experience kidney infection every year, and females are six times more likely to experience the infection than males. It was informative to read that people who are at risk of acute pyelonephritis include those with type 1 and type 2 diabetes, patients who are pharmacologically immunocompromised, individuals experiencing stress incontinence, adults who engage in anal sex, those with structural or congenital abnormalities that may obstruct urinary flow, and patients who have or have had an indwelling urinary catheter. It is important that healthcare professionals caring for these individuals are aware of their increased risk of developing the condition to provide timely treatment and prevent infection. Most cases of pyelonephritis are caused by a Gram-negative bacterial infection, usually Escherichia coli. The clinical presentation can vary depending on age, cognitive ability to express symptoms and the severity of the condition. Therefore diagnosis can be challenging at times. Signs and symptoms of the condition include offensive-smelling urine, flank pain, haematuria and polyuria, dysuria and urgency, tachycardia and tachypnoea, fever, anorexia and nausea, and systemic ill health, rigor and chills. Because of the inconsistency of signs and symptoms of pyelonephritis, certain diagnostic and investigative procedures, such as urinalysis or
MASTERFILE
A CPD article has increased Brenda Chivima’s awareness of the care of people with an acute urinary tract infection
who exhibit symptoms of systemic illness, young infants, older patients who are frail and have poor social support, patients who are immunocompromised or have an anatomical abnormality or obstruction of the urinary tract, and those with suspected systemic sepsis, progression of a previously uncomplicated urinary tract infection and an uncertain diagnosis.
Vital advice
blood culture, may be required to enhance diagnostic accuracy. Most patients with pyelonephritis are treated successfully with oral medication on an outpatient basis, with review and follow up. However, some patients will require hospitalisation, including those experiencing persistent vomiting and/or clinical evidence of dehydration, pregnant women
This practice profile is based on NS663 Bethel J (2012) Acute pyelonephritis: risk factors, diagnosis and treatment. Nursing Standard. 27, 5, 51-56.
Nurses have an important role in providing care and education for patients with acute pyelonephritis. They can advise patients on the importance of maintaining personal and sexual hygiene; maintaining adequate hydration, particularly in high-risk groups such as those with diabetes or those who are immunocompromised; being aware that there is an increased risk of pyelonephritis during pregnancy and that certain comorbidities may make individuals more vulnerable to the condition. Also, nurses administer medication, monitor the progress of hospitalised patients with pyelonephritis, and should treat patients with compassion, sensitivity and respect. After reading the CPD, I am now more knowledgeable about pyelonephritis, and am better able to provide care and education to patients with the condition NS Brenda Chivima is a nursing student at the University of the West of England
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 51 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
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Pyelonephritis Acute pyelonephritis refers to a lower urinary tract infection that has spread to the pelvis of the kidney. An estimated one in 830 people in the UK experience kidney infection every year, and females are six times more likely to experience the infection than males. It was informative to read that people who are at risk of acute pyelonephritis include those with type 1 and type 2 diabetes, patients who are pharmacologically immunocompromised, individuals experiencing stress incontinence, adults who engage in anal sex, those with structural or congenital abnormalities that may obstruct urinary flow, and patients who have or have had an indwelling urinary catheter. It is important that healthcare professionals caring for these individuals are aware of their increased risk of developing the condition to provide timely treatment and prevent infection. Most cases of pyelonephritis are caused by a Gram-negative bacterial infection, usually Escherichia coli. The clinical presentation can vary depending on age, cognitive ability to express symptoms and the severity of the condition. Therefore diagnosis can be challenging at times. Signs and symptoms of the condition include offensive-smelling urine, flank pain, haematuria and polyuria, dysuria and urgency, tachycardia and tachypnoea, fever, anorexia and nausea, and systemic ill health, rigor and chills. Because of the inconsistency of signs and symptoms of pyelonephritis, certain diagnostic and investigative procedures, such as urinalysis or
MASTERFILE
A CPD article has increased Brenda Chivima’s awareness of the care of people with an acute urinary tract infection
who exhibit symptoms of systemic illness, young infants, older patients who are frail and have poor social support, patients who are immunocompromised or have an anatomical abnormality or obstruction of the urinary tract, and those with suspected systemic sepsis, progression of a previously uncomplicated urinary tract infection and an uncertain diagnosis.
Vital advice
blood culture, may be required to enhance diagnostic accuracy. Most patients with pyelonephritis are treated successfully with oral medication on an outpatient basis, with review and follow up. However, some patients will require hospitalisation, including those experiencing persistent vomiting and/or clinical evidence of dehydration, pregnant women
This practice profile is based on NS663 Bethel J (2012) Acute pyelonephritis: risk factors, diagnosis and treatment. Nursing Standard. 27, 5, 51-56.
Nurses have an important role in providing care and education for patients with acute pyelonephritis. They can advise patients on the importance of maintaining personal and sexual hygiene; maintaining adequate hydration, particularly in high-risk groups such as those with diabetes or those who are immunocompromised; being aware that there is an increased risk of pyelonephritis during pregnancy and that certain comorbidities may make individuals more vulnerable to the condition. Also, nurses administer medication, monitor the progress of hospitalised patients with pyelonephritis, and should treat patients with compassion, sensitivity and respect. After reading the CPD, I am now more knowledgeable about pyelonephritis, and am better able to provide care and education to patients with the condition NS Brenda Chivima is a nursing student at the University of the West of England
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 51 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
NURSING february :: vol uses 28 no 23 :: permission. 2014 61 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 22, 2015. For personal use only. No5 other without Copyright © 2015 RCNi Ltd. All rights reserved.
