- Acute Pain related to Inflammation and infection of the urinary tract as evidenced by Reports of pain/burning/discomfort when urinating and Spasm in the bladder and lower back
- Deficient Fluid Volume related to Inflammatory process and Insufficient fluid intake as evidenced by Altered skin turgor and Thirst
- Hyperthermia related to Inflammatory process secondary to pyelonephritis as evidenced by Increased body temperature above the normal range and Chills
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain related to Inflammation and infection of the urinary tract as evidenced by Reports of pain/burning/discomfort when urinating and Spasm in the bladder and lower back | Patient will verbalize an absence of flank pain and dysuria. Patient will report satisfactory pain control at a level of less than 3 on a scale of 0-10. | 1. Administer medications as indicated. Antibiotics are prescribed to treat the infection. Antipyretics like acetaminophen are prescribed to help reduce fever and pain. 2. Increase fluids as ordered. Adequate fluid intake at 2 liters per day will help with urine dilution, promote renal blood flow, reduce bladder irritation, and flush bacteria from the urinary tract. 3. Encourage the patient to avoid urinary tract irritants. Sodas, spices, tea, alcoholic beverages, and coffee are considered urinary tract irritants and should be avoided. 4. Encourage the patient to void frequently. Frequent voiding will help to empty the bladder, avoiding bladder distention, reducing urine stasis, preventing reinfection, and lowering bacterial count. Patients may be hesitant to void due to pain but should be educated on these reasons. 5. Assist the patient in using non-pharmacologic techniques for pain management. Alternative therapies like positioning, heat, relaxation, and guided imagery can help decrease pain, offer distraction, and promote comfort for the patient. 6. Educate the patient about the disease process, prognosis, and treatment regimen. Patient education is vital to ensure understanding of the disease process and prevention. Stress the importance of completing antibiotic therapy to prevent antibiotic resistance and reinfection. | Patient verbalized an absence of flank pain and dysuria. Patient reported satisfactory pain control at a level of less than 3 on a scale of 0-10. |
| Subjective data: Verbalizes increased thirst Objective data: -Decreased blood pressure -Dry skin -Dry mucous membranes -Increased heart rate -Increased body temperature -Thirst -Loss of appetite Weakness | Deficient Fluid Volume related to Inflammatory process and Insufficient fluid intake as evidenced by Altered skin turgor and Thirst | Patient will maintain blood pressure, body temperature, and heart rate within normal limits. Patient will remain free from any signs and symptoms of dehydration, including dry skin, dry mucous membranes, and altered mental status. | 1. Monitor the patient’s intake and output. Urine output is an accurate indicator of fluid balance. An increase or decrease in urine output can indicate kidney injury, infection, or inflammation, further complicating hypovolemia and dehydration. 2. Encourage increased fluid intake. Adequate fluid intake is encouraged in patients with pyelonephritis, as this condition is characterized by excessive urine production due to infection and inflammation of the kidneys. Adequate fluid intake helps with fluid replacement and prevents dehydration. 3. Administer intravenous fluid therapy as indicated. For severe cases of pyelonephritis, the patient may need to be admitted to the hospital with intravenous fluid replacement to resolve deficient fluid volume and prevent dehydration. 4. Prevent further fluid loss. Patients who exhibit fever, vomiting, or diarrhea require antipyretics, antiemetics, and antidiarrheals to prevent further fluid loss. 5. Monitor for complications. Pyelonephritis can result in urosepsis which is characterized by bacteriuria and bacteremia. It is vital to closely monitor and observe the patient for signs and symptoms of septic shock to prevent further decline in the patient’s intravascular volume. | Patient maintained blood pressure, body temperature, and heart rate within normal limits. Patient remained free from any signs and symptoms of dehydration, including dry skin, dry mucous membranes, and altered mental status. |
| Subjective data: Verbalizes increased body temperature Objective data: -Increased body temperature above the normal range -Chills -Warm, flushed skin -Diaphoresis -Tachycardia -Tachypnea | Hyperthermia related to Inflammatory process secondary to pyelonephritis as evidenced by Increased body temperature above the normal range and Chills | Patient will maintain core body temperature within the normal range. Patient will maintain vital signs within normal limits | 1. Provide a tepid sponge bath as needed A sponge bath with tepid water will reduce fever by dilating the superficial blood vessels, ultimately releasing heat and lowering body temperature. Do not induce shivering as this is the body’s attempt to increase temperature. 2. Encourage adequate fluid intake. Adequate fluid intake will help prevent dehydration, which is precipitated by the increase in body temperature. 3. Maintain bed rest. Adequate rest allows the reduction of metabolic demands and oxygen consumption, resulting in a decrease in body temperature. 4. Administer antipyretic medications as indicated. Antipyretic medications reduce prostaglandin synthesis to lower body temperature. | Patient maintained core body temperature within the normal range. Patient maintained vital signs within normal limits |