Nursing: Renal Disorder, Essay Example

Personal and Medical History

Personal history

Mr. A.P, a 70 year old African male was brought to the emergencyat one o’clock in the morning complaining of pain on micturition and in the cost vertebral region; blood in the urine and low grade fever for three days. A personal history revealed that Mr. A.P worked for 35 years as a laborer on a farm where his hours of work extended from six in the morning to about 10 -11 at nights. Workers on this farm were given two hours break for lunch between 12 noon and 2 o’clock during the day. He admitted to standing for exceptionally long hours during the day and often complained of back pain for which he occasionally took pain pills as part of his coping skills’ strategy. Also he said that due to the type of work there was a tendency to hold his urine until when time was available to visit the bathroom which was some distance away from the farm area.

Medical History

Mr.A.P has a history of mild hypertension being controlled with medication. He appear slightly overweight even through six feet tall, the record weight was 230 pounds being bulky abound the abdomen. This was the first time he was experiencing these symptoms and has not seen a doctor in twenty years except for refilling his hypertension medication which was done through his primary care clinic in the community where he lived. This patient denied ever having fever any time before in his life, but said that he can recognize when it is happening since he has twelve children. After examination and urine culture pyelonephritis was diagnosed. Temperature reading was 39.0 degree centigrade.

Drug Therapy and treatment

Drug therapy depends on results obtained from urine culture and sensitivity.Antibiotics are selected targeting destruction of the infecting organism/s. Since pyelonephritis is caused by an ascending bacterial infection, antibiotics are always the first line intervention after a culture and sensitivity. It is always recommended that treatment begins after reports have returned regardless of how much pain patients complain of. Whileawaiting culture resultsanalgesics are administered treatment in an attempt to alleviate pain (Williams & Craig, 2011).

The choice of antibiotics includescephalosporins,fluoroquinolones, trimethoprim/sulfamethoxazole or aminoglycosides. They can be administered as single drug therapies a in combination depending on the causative organism resistance to antibiotic intervention. Vitals are monitored during treatment apart from further culture and sensitivity testing to determine the organism’s response to antibiotic therapy. Usually, if there is a high prevalence resistance to antibiotics these patients are monitored in hospital for a few days (Wang, Fang & Chen, 2012).

Pyelonephritis is an advanced stage of urinary tract infection. The onset may be as-symptomatic, but as the infection moves from theurethra into the bladder and further upward into the glomerulus the condition could be considered acute producing costo-vertebral pain; difficulty in urination; fever and bloody urine. The disorder is more common in women than men (Hultgren, 2011).

Follow up

Follow up management encompasses preventing recurrence of the infection since many patients tend to have episodes requiring further evaluation. Education includes practicing proper hygiene during urination. Adapt measures for improving nutrition infacilitating the body’s ability incombating invasion of harmful organism. Also it is advised to seek medical attention immediately if any signs and symptoms recur (Gupta, Hooton, Naber, Wullt,Colgan& Miller, 2011).

References

Gupta, K. Hooton, T. Naber, K. Wullt. B. Colgan, R., & Miller, L. (2011). International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical Infectious Diseases, 52 (5); e103–20. doi:1

Hultgren, S.(2011). Pathogenic Cascade of E. coli UTI.UTI Pathogenesis. St. Louis, Missouri: Molecular Microbiology and Microbial Pathogenesis Program, Washington University.

Wang, C. Fang, C., & Chen, N. (2012). Cranberry-containing products for prevention of urinary tract infections in susceptible populations. Arch Intern Med 172 (13): 988–96.

Williams, G., & Craig, J. (2011).  Long-term antibiotics for preventing recurrent urinary tract infection in children.Cochrane Database of Systematic Reviews, 2011 (3); CD001534.