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College of Nursing
S. Y. 2009 – 2010
CASE STUDY ON
Acute Pyelonephritis (APN)
SUBMITTED BY:
SUBMITTED TO:
28 JULY 2009
I. PERSONAL DATA
When she was a child, she have had experienced measles and chicken pox but was not medically diagnosed.
According to the patient’s mother, the patient has the BCG, Hepa B, Typoid, Tetanus & Diphtheria vaccines at
childhood. Last July 10, 2009, the patient was admitted at the Ospital ng Makati due to complaint of severe headache,
muscle pain, fever, and rashes. On that date, she was medically diagnosed of Dengue.
In July 19, 2009 she was returned to the Emergency room having the chief complaint of difficulty in urinating, intolerable
abdominal pain, and fever. She was diagnosed of Acute Pyelonephritis. Since the time of her admission up until to date, the
patient is experiencing imbalance body temperature.
III. PHYSICAL ASSESSMENT – VITAL SIGNS
IV. MEDICATION
V. CASE STUDY
Patient ABC was diagnosed of Acute Pyelonephritis (APN) at the Ospital ng Makati after she complained for difficulty in urinating,
intolerable abdominal pain, and fever last July 19, 2009. Her attending physician ordered for her confinement at the
aforementioned hospital.
Acute pyelonephritis is an infection of the upper urinary tract, specifically the renal parenchyma and
renal pelvis (Figure 1). Acute pyelonephritis is considered uncomplicated if the infection is caused by a typical pathogen in an
immunocompetent patient who has normal urinary tract anatomy and renal function. Misdiagnosis can lead to sepsis, renal
abscesses, and chronic pyelonephritis that may cause secondary hypertension and renal failure. Risk factors for complicated
acute pyelonephritis are those that increase susceptibility or reduce host response to infections
In more than 80 percent of cases of acute pyelonephritis, the etiologic agent is Escherichia coli.
Approximately 250,000 cases of acute pyelonephritis occur each year, resulting in more than 100,000 hospitalizations.3 Women
are approximately five times more likely than men to be hospitalized with this condition (11.7 versus 2.4 hospitalizations per
10,000 cases, respectively); however, women have a lower mortality rate than men (7.3 versus 16.5 deaths per 1,000 cases,
respectively). There are four acute pyelonephritis occurs in one to two percent of pregnant women, increasing the risk for
premature labor and low-birth-weight infants.
Pathogenesis
Findings and observations show client’s poor hygienic practices as evidenced by not doing handwashing after using a public toilet,
not changing untidy clothes, poor oral hygiene.
This disease is commonly to women. Anatomically means, women have shorter urethra than men. Secondly, anus as a sort of e.
coli reservoir is close to vaginal canal which is the traveling point of e. coli from the anus thru urethra, bound for bladder to the
kidney. In which kidney is the human’s physiological asset responsible for waste elimination. A severe damage to kidney causes
APN. A justification to conclude the patient’s case for having APN.