allan case study 1

8/6/2019 Allan Case Study 1

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CASE STUDYON

ACUTE

PYELONEPHRITIS

PRESENTED BY:

JEAN ROSEARGONZA

PRESENTED TO:

LIEZEL B. CAUILAN

DATE OF SUBMITTED:

JANUARY 29, 2011


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CASE STUDY OF ACUTE PYELONEPHRITIS

General Objectives:

I studied this case in order to broaden my knowledge on acute pyelonephritis are

related the importance of effective caregiver management in dealing with the manifestation and

complications of the disease.

Specific Objectives:

At the end, I will be able to define Acute Pyelonephritis. To determine signs and

symptoms of the disease. Relate the anatomy and physiology of the disease. Identify appropriate

caregivers management in providing quality health care to my patient. List the factors that

predisposed patient to have acute pyelonephritis. Familiarize myself with the disease process and

the treatment of acute pyelonephritis.

INTRODUCTION

Pyelonephritis is a bacterial infection of the renal pelvis, tubules and interstitial

tissues of one or both kidneys. Causes involve either the upward spread of bacterial from the

bladder or spread from systemic sources reaching the kidney via the bloodstream. Pathogenic

bacteria from a bladder infection can ascend into the kidneys resulting in pyelonephritis. An

incompetent ureterovesical valve or obstruction occurring in the urinary tract increases the

susceptibility of the kidneys to infection, because static urine provides a good medium for


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bacterial growth. That causes bladder tumor, strictures, benign prostatic hyperplasia, urinary

stones, [there causes obstruction which can lead to infection], systemic infection such as

tuberculosis [these can be spread to the kidneys and result in abscesses.

Pyelonephritis may be acute or chronic. Acute pyelonephritis is usually

manifested by enlarged kidneys with interstitial infiltrations of inflammatory cells. Abscesses

may be noted on or within the renal capsules and the corticomedullary junction. Atrophy and

destruction of tubules and the glomeruli may result. When pyelonephritis becomes chronic the

kidney become scarred, contracted and none functioning. Chronic pyelonephritis is a cause of

chronic kidneys disease that can result in the need for renal replacement therapies such as

transplantation or dialysis.

CENSUS

Region II-85,350

Philippines- 2,587,250

CLINICAL MANIFESTATION

y Chillsy Flank painy Nausea and vomitingy Headachey Malaisey Painful urinationy Pain and tenderness in the area of the costovertebral angley Urinary urgencyy Urinary frequency


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PATIENT PROFILE

NAME: Mr. E

AGE: 36 years old

BIRTH DAY: Sep. 5 1974

ADDERESS: Cataraun, Amulung

GENDER: Male

STATUS: Married

RELIGION: Roman Catholic

CHIEF COMPLAINT: Left lower quadrant

DATE OF ADMISSION: January 18 2011

TIME

OF ADM

ISSION:

11 PM

ATTENDING PHYSICIAN: Dra. Rowena Soliman and Dr. Thomas Uy

HISTORY

y History of Past illnessHe was been confined at the clinic of Dr.Velarde last year,December 30

2010 because he was been diagnosed ofUrinary Tract Infection.


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History of Present illness

Few hours prior to admission patient complaint of his left lower quadrant

pain. He was admitted at Tuguegarao City Peoples General Hospital in

few days to cure the pain.

y History of chief complaintHe was been felt pain at the left lower quadrant of his kidney.

ANATOMY and PHYSIOLOGY

The principal function of the urinary system is to maintain the volume and composition

of body fluids within normal limits. One aspect of this function is to rid the body of waste

products that accumulate as a result of cellular metabolism. Other aspect of its function includes

regulating the concentrations of various electrolytes in the body fluids in maintaining normal ph

of the blood.

In addition to maintaining fluids homeostasis in the body, the urinary systems control the

red blood cell production by secreting the hormone erythropoietin. The urinary system also plays

a role in maintaining normal blood pressure by secreting the enzyme rennin.


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The urinary system consists ofthe kidneys, ereters, urinary bladder and urethra.

The kidneys form the urine and account for the other function attributes to the urinary system.

The kidneys are divided into an outer cortex and

inner medulla which surround the renal sinus.

The bases of several con-shaped renal pyramids

are located at the boundary between the cortex

and the medulla, and the tips of the renal

pyramids project toward the center of the

kidney. The ureters carry the urine away from

kidney to the urinary bladder, which is a temporary reservoir for the urine. The urinary

bladder is a hallow muscular container that lies the pelvic cavity just posterior to the public

symphysis. It functions to stored urine, and its size depends on the quantity of urine present. The

urinary bladder can hold from a few millimeters to a maximum of about 1000 ml of urine. The

urethra is a tubular structure that carries the urine from the urinary bladder to the outside.


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MEDICAL MANAGEMENT

Two weeks course of antibodies: ampicilin, contrimoxasole, ciprofloxacin

Two or three day parenteral antibiotic therapy for pregnant women. Oral

antibiotic agent may be prescribed once patient is a febrile and showing clinical

movements

Six weeks antibiotics therapy if relapse occurs them a follow up urine cultures is

obtained two weeks after completion of antibodies therapy to document clearing

of the infection

Hydration with oral or parenteral fluids for adequate kidneys function and these helps

facilitate flushing of the urinary tract and reduces pain and discomfort.Complecation

repeated about of acute pyelonephritis may lead to chronic pyelonephritis such

complications of chronic pyelonephritis include end stage renal disease from

progressive loss of nephrons secondary to chronic inflammation and scaring,

hypertension and formation of kidney stones from chronic infection with urea splitting

organism.

CAREGIVER MANAGEMENT

y Assess patient vital signsy Active patient to verbalize concerny Provide comforty Increased fluid intakey Change Lifestyle of the patient and decrease fat, cholesterol and salt.


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Case study of Acute Respiratory Infection

Objectives:

General

I studied this case, to gain more knowledge about acute respiratory infection in

order to apply and effective caregiver management in dealing with this disease.

Specific

In my own research I will be able to define acute respiratory infection, to determine

the sign and symptoms and to be able to provide caregiver management on high quality health

education.


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Introduction:

The common cold is a viral infection of the upper respiratory system, including the

nose,throat,sinuses,Eustachian tubes,trachea,larynx,and bronchial tubes .Although more than200 different viruses can cause a cold, 30-50% are caused by a group known as rhino viruses or

corona viruses infection, are the most common illness to strict any part of the body. It is

estimated that the average person has more than 50 colds during a lifetime.any one can get a

cold, although pre-school and grade school children can catch them more frequently than

adolescent and adults. Repeated exposure to viruses causing colds creates partial immunity.

Although most colds result on their on without complication, there are a leading cause of visits

to the doctor and of time lost from work and school. Treating sympyoms of the common colds

has given rise to a multimillion dollar industry in over the country medication.

Colds season in the United States begins in early autumn and extend through early spring.

Although it is not true that getting wet or being in a draft causes a colds ( a person has to come

in contact with the virus to catch a colds), certain condition may lead to increase susceptibility.

These include:

y Fatigue and over worky Emotional stressy Poor nutritiony Smokingy Living or working in crowded condition

Colds make the upper respiratory system less resistant to bacterial infection. Secondary

bacterial infection may lead to middle ear infection, bronchitis, pneumonia, sinus infection,

strep throat. People with chronic lung disease, asthma, diabetes or a weaken immune system

are more likely to develop this complication


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PATIENT PROFILE

Name: Ms. A

Age: 48

Birth day: December 20 1962

Address: Ugac Sur

Gender: Female

Status: Married

Religion: Roman Catholic

Chief Complaint: Cough and colds

Date of Admission: January 19 2011

Time of Admission: 10:00 am

Admitting Physician: Dr. Tallud

History

History of past illness

According to the patient she suffers cough, cold.She take neozep and amoxicillin.

History of present illness

6 days prior to admin patient complain of cough and colds few hours PTA worsen, hands

patient sought consultation here at Tuguegarao City Peoples General Hospital.


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History of chief complaint.

The patient complains of cough and cold.

Medical management

Avoiding intubation is a major goal in the management of respiratory failure, particularly in

immunosuppressed patient.Neverless; there are only limited data on the efficacy of non

invasive ventilation in these high risk patients.

The medical management of patient with acute respiratory infection failure will vary depending

on the cause and type of failure. Treatment should be targeted at the cause. Therapeutic goal

should focus on preventing cellular damage and relieving patients symptoms and distress.

Airway obstruction is a clinical emergency. If this is the cause of respiratory failure it should be

treated and safe airway maintained as a priority. This may require simple clearance such as the

removal of foreign body, secretion using suction. Patient positioning and manipulation of the

airway will be required to open it if obstructed.

Caregiver management

y Washing hand well and frequently, especially after touching the nose or before handling food.y Covering the mouth and nose when sneezingy Disposing of use tissues properlyy Avoiding close contact with someone who has a cold during the first two to four days of their

infection

y Not sharing food, eating utensils or cups with anyoney Avoiding crowded places where cold germs can spready Eating a healthy diet and getting adequate sleep

allan case study 1

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