Medical Surgical UTI & Pyelonephritis #4

Question

The nurse prepares discharge planning for a hospitalized client who is diagnosed with pyelonephritis. Which instruction will the nurse provide the client and family for home management? Select all that apply.

Answers

  1. Weigh daily at the same time and report gains or losses.
    • Rationale:

      This answer is correct because daily weights using the same scale at the same time of day with the same amount of clothing will assist in monitoring the client’s fluid balance; therefore, this is an appropriate topic for the nurse to include in the discharge instructions for a client who is diagnosed with pyelonephritis.

  2. Warm baths may be taken for pain relief.
    • Rationale:

      This answer is correct because the client who is diagnosed with pyelonephritis often experiences back pain in addition to side and groin pain. One method to manage this pain is through the use of warm baths; therefore, this is an appropriate topic for the nurse to include in the discharge instructions for a client who is diagnosed with pyelonephritis.

  3. Eat a high calorie, low protein diet.
    • Rationale:

      This answer is correct because a low protein, high calorie diet is important for the client who is diagnosed with pyelonephritis to avoid the build-up of protein waste products in the body that can occur due to poor kidney function; therefore, this is an appropriate topic for the nurse to include in the discharge instructions for a client who is diagnosed with pyelonephritis.

  4. Limit fluids to 800 mL daily.
    • Rationale:

      This answer is not correct because the client who is diagnosed with pyelonephritis is taught to increase, not decrease, their daily fluid intake; therefore, this topic is not included by the nurse in the client’s teaching plan for discharge.

  5. Take all medications prescribed until finished.
    • Rationale:

      This answer is correct because taking all medication prescribed until finished, even if you start to improve, is important to prevent the infection from recurring. A return infection could potentially be more difficult to treat.

Overview

Pyelonephritis is defined as a bacterial kidney infection. Pyelonephritis is due to a specific type of urinary tract infection (UTI) that begins in the urethra or bladder and then travels to the client’s kidneys.

Explanation

Learning Outcomes

Pyelonephritis is due to a specific type of urinary tract infection (UTI) that begins in the urethra or bladder and then travels to the client’s kidneys. Fever, frequent urination, and pain (e.g., back, side, groin) are common symptoms of pyelonephritis. Discharge instructions from the nurse are essential for home management. The nurse should instruct the client on the importance of daily weight to monitor fluid balance; eating a high calorie, low protein diet; and taking warm baths for pain relief. In addition, the client is taught to increase fluid intake to approximately 3L/day to maintain an output of at least 1.5 L/day.

Test Taking Tip

Consider evidence-based practice guidelines for the management of pyelonephritis to answer this question correctly.

Video Rationale