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Medical management
Acute Pyelonephritis
Usually treated as outpatient if they are not dehydrated, not
Hypovolemic Shock
Nursing Management
Acute Pyelonephritis
Fluid intake and output are carefully measured and recorded. Unless contraindicated ,
fluid are encouraged (3-4 l/day) to dilute the urine, decrease burning on urination, and
prevent dehydration.
Assesses the patients temperature every four hours and administers antipyretic and
antibiotic agents as prescribed
Patients teaching focus on prevention of UTIs
Hypovolemic Shock
Ensuring patent airway and maintaining breathing are crucial. Additional ventilatory
assistance is given as required. A rapid physical examination is performed to determine
the cause of shock.
Facilitate rapid fluid and blood replacement as prescribed
Elevate patient feet slightly to improve cerebral circulation and promote venous return
to the heart. However, this position is CONTRAINDICATED for patients with head injury
Instruct patient to avoid unnecessary movement
An indwelling urinary catheter is inserted as prescribed to record urinary output every
hour. Urine volume indicates the adequacy of kidney perfusion
Ongoing nursing surveillance of the total patient is maintained. Vital signs, skin
temperature, color, pulse oximetry, neurologic status, CVP, arterial blood gases ECG
recordings, hematocrit, hemoglobin, coagulation profile,electrolytes, and urinary output
are monitored serially to assess patient response to treatment.
Reassured and comfort the patient
Body temperature is maintained within normal limits to prevent increasing metabolic
demands that the body may be unable to meet.