Acute Pain and Anxiety related to Pyelonephritis

Pyelonephritis is a type of urinary tract infection (UTI) that affects one or both kidneys.

Pyelonephritis is caused by a bacterium or virus infecting the kidneys. Though many bacteria and viruses can cause pyelonephritis, the bacterium Escherichia coli is often the cause. Bacteria and viruses can move to the kidneys from the bladder or can be carried through the bloodstream from other parts of the body. A UTI in the bladder that does not move to the kidneys is called cystitis.

Symptoms of pyelonephritis can vary depending on a person’s age and may include the following:

• fever
• vomiting
• back, side, and groin pain
• chills
• nausea
• frequent, painful urination

Nursing Diagnosis : Acute Pain related to infection of the kidneys

Goal: pain in the kidneys is reduced

Expected outcomes: No pain on urination, no pain on percussion pelvis.

Interventions and Rationale

1. Assess the intensity, location, and factors that aggravate or relieve pain.
R /: Pain is a great sign of infection.

2. Give adequate rest and activity levels that can be tolerant.
R /: Clients can rest and muscles can relax.

3. Encourage drinking plenty of 2-3 liters if no contraindications
R /: To assist clients in urination.

4. Give analgesics according to the treatment program.
R /: Analgesic block the path of pain.

5. Monitor urine output to changes in color, odor and voiding patterns, input and output every 8 hours and monitor the results of urinalysis repeated.
R: To identify indications of progress or deviations from expected results.

6. Record the location, the length of the intensity scale (1-10) spread pain.
R /: To help evaluate the place of obstruction and cause pain.

7. Provide comfortable action, bleak back rub, the rest.
R /: Improve relaxation, reduce muscle tension.

8. Assist or encourage the use of focused relaxation breathing.
R /: Helps redirect the attention and for muscle relaxation.

9. Give perineal care.
R /: To prevent contamination of the urethra.


Nursing Diagnosis: Anxiety related to lack of information about the disease process, prevention methods, and home care instructions.

Goal: Anxiety is reduced

Expeected Outcome : Clients say taste anxiety diminished

Interventions and Rationale:

1. Assess the level of anxiety.
R /: To determine the severity of the client's anxiety.

2. Give the client the opportunity to express feelings.
R /: In order for the client to have passion and want empathy to care and treatment.

3. Give support to the client.

4. Give spiritual encouragement.

5. Give an explanation of the illness.
R /: In order to fully understand the client's illness experiences.

Anxiety - NCP for Pulmonary Edema

Pulmonary edema is an abnormal buildup of fluid in the air sacs of the lungs, which leads to shortness of breath.

Early symptoms of pulmonary edema include:

• shortness of breath upon exertion
• sudden respiratory distress after sleep
• difficulty breathing, except when sitting upright
• coughing

In cases of severe pulmonary edema, these symptoms will worsen to:

• labored and rapid breathing
• frothy, bloody fluid containing pus coughed from the lungs (sputum)
• a fast pulse and possibly serious disturbances in the heart's rhythm (atrial fibrillation, for example)
• cold, clammy, sweaty, and bluish skin
• a drop in blood pressure resulting in a thready pulse

The health care provider will perform a physical exam and use a stethoscope to listen to your lungs and heart. The following may be detected:

• Abnormal heart sounds
• Crackles in your lungs, called rales
• Increased heart rate (tachycardia)
• Pale or blue skin color (pallor or cyanosis)
• Rapid breathing (tachypnea)

Nursing Diagnosis : Anxiety related to Threat / Change in Health Status

Goal: Anxiety can be overcome

Expected outcomes:

• Reported fear / anxiety disappear or decrease to the level that can be handled, looks relaxed and resting / sleeping properly.

Nursing Intervention :

1) Record the degree of anxiety and fear. Inform the patient / person close to the patient, the normal feelings and push expressing feelings.
Rational:
Understanding that feelings (which are based plus oxygen imbalances that threaten) normal can help patients improve some sense of emotional control.

2) Explain the disease process and procedures in the level of the patient's ability to understand and handle information. Assess the current situation and the measures taken to address the problem.
Rational:
Eliminate anxiety as insecurity and reduce fear about personal safety. In the early phase of explanation needs to be repeated with frequent and short because the patient has decreased the scope of attention.

3) Provide comfort measures, ie, back massage, change of positions.
Rational:
Tool to reduce stress and indirect care to enhance relaxation and coping skills.

4) Help patients to identify behavioral help, eg a comfortable position, focus on breathing, relaxation techniques.
Rational:
Giving patients control measures to reduce anxiety and muscle tension.

5) Support the patient / significant other in accepting the reality of the situation, especially the plan for a long period of recuperation. Involve patients in planning and participation in care.
Rational:
Coping mechanisms and participation in treatment programs may improve learning patients to receive the expected result of the disease and improve some sense of control.

6) Watch out for out of control behavior or increased cardiopulmonary dysfunction, eg worsening dyspnea and tachycardia.
Rational:
Developing the capacity of anxiety requires further evaluation and possible intervention with anti-anxiety medication.