Nursing care plan for acute pyelonephritis

Nursing care plan for acute pyelonephritis

Introduction to Nursing Care Plan for Acute Pyelonephritis

Acute pyelonephritis is a bacterial infection of the kidneys and the renal pelvis. It can be caused by ascending or hematogenous spreading of bacteria from the bloodstream, and is typically marked by flank pain, fever, chills, and hematuria. The disease is diagnosed with a combination of physical examination, cultures, imaging studies, and renal function tests.

Nursing Assessment for Acute Pyelonephritis

  • Signs & Symptoms: Typical symptoms that suggest acute pyelonephritis includes fever with chills, nausea, vomiting, left-sided or right-sided abdominal pain, loss of appetite, malaise, fatigue, and cloudy urine.
  • Laboratory Data: Urinalysis and urine culture with sensitivity of organisms is also used to diagnose acute pyelonephritis.

Nursing Diagnosis for Acute Pyelonephritis

The possible nursing diagnoses associated with acute pyelonephritis include:

  • Ineffective Health Maintenance: Impaired ability to recognize signs and symptoms of a health problem or potential problems.
  • Risk for Infection: Invasive procedures, underlying conditions that compromise immunological defenses, or contact with an infected person increase the likelihood of an infectious process.
  • Ineffective Protection: impaired capability to safeguard self from environmental hazards.
  • Acute Pain: Unpleasant sensation accompanying tissue damage resulting from various stimuli.

Expected Outcomes of Nursing Care Plan for Acute Pyelonephritis

  • Patient will:
  • Identify and verbalize specific signs and symptoms associated with his/her condition.
  • Demonstrate behaviors that promote maintenance of immunological defense.
  • Verbalize understanding of self-care measures.
  • Use interventions effectively to reduce/manage pain.

Interventions for Acute Pyelonephritis

  • Assess the accuracy and completeness of the patient’s health status.
  • Monitor vital signs and the patient’s level of comfort.
  • Provide hygiene measures, such as bed baths, sponge baths, and perineal care, as appropriate.
  • Provide explanations and education related to diagnosis, treatment, and measures to prevent recurrence.
  • Encourage patient to express feelings/get emotional support from family members.
  • Help the patient set attainable goals for improved health.
  • Administer medications as prescribed to reduce symptoms and speed recovery.

Rationales for Interventions for Acute Pyelonephritis

  • Assessment helps identify areas of actual/potential problems.
  • Pertinent vital signs indicate severity and effectiveness of treatment.
  • Hygiene measures are important to promote comfort and prevent complications, such as nosocomial infections.
  • Nursing explanation, patient/family education, and goal setting help the patient develop knowledge and improved self-care.
  • Clinically indicated medications are administered to assist in controlling symptoms & speed recovery.


  • Observe patient’s response to the treatment.
  • Monitor for fluctuations in temperature, pulse, and respirations.
  • Note any improvements in signs or symptoms.
  • Monitor laboratory studies indicating evidence of infection.
  • Reassess the patient’s understanding of disease process and therapeutic measures.


Healthcare professionals must be mindful of the important components of nursing care for the patient with acute pyelonephritis. Thorough initial assessment, accurate diagnosis and timely implementation of the nursing interventions and strategies are essential for successful outcomes.


  1. What is acute pyelonephritis?
    Acute pyelonephritis is a bacterial infection of the kidneys and the renal pelvis that can cause flank pain, fever, chills, and hematuria.
  2. How is acute pyelonephritis diagnosed?
    Acute pyelonephritis is commonly diagnosed on the basis of history, physical examination, laboratory investigations such as urine culture, and imaging studies.
  3. What are the nursing interventions for acute pyelonephritis?
    The nursing interventions for acute pyelonephritis include assessment, monitoring of vital signs, providing hygiene measures, providing patient/family education, administering medications, and evaluating the patient’s response to the treatment.
  4. What is the prognosis for acute pyelonephritis?
    Acute pyelonephritis often resolves with antibiotic therapy and supportive care within two to three weeks. Complications can arise which may lead to longer term morbidity.
  5. What preventive measures can be taken to help avoid pyelonephritis?
    Maintaining good hygiene and avoiding exposure to known sources of infection (e.g., contaminated water) are important preventive measures that can be taken to help avoid pyelonephritis.

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