The leading problem of care in chronic pyelonephritis is a lack of knowledge in a patient about its disease, the risk factors of exacerbations, the possible adverse outcome of the disease and measures to prevent it.
Content
Who is sick pyelonephritis
Pyelonephritis (including chronic) people are more often sick of young and medium
age leading mainly active lifestyle. This category of patients,
trying not to think about your illness, it is especially important to learn to reckon with it
and not provoke the development of complications.
What is pyelonephritis? This is an infectious inflammation of the renal fabric (tissue,
which forms the kidney frame), cups and lochs (these kidney structures are collected
and remove urine in the ureter). It can be sharp, and may go to chronic
Form. Such inflammation is caused by various bacteria.
The source of infection can be:
- carious teeth;
- chronic tonsillitis;
- furunculosis;
- cholecystitis;
- inflammation of the urethra, bladder;
- Inflammation of the prostate gland, ovarian.
What factors contribute to the emergence of the disease or exacerbation of the already existing?
- Violation of the outflow of urine (stones, urinary inflection, their narrowing, omit
kidneys, pregnancy, etc.);
- Weakening of the body: reduced resistance to infection as a result
overwork, low content of vitamins in food, excessive cooling;
- A number of diseases available (diabetes mellitus, tuberculosis, liver disease).
Chronic pyelonephritis is usually a consequence of not cured acute pyelofrit,
But often from the very beginning, the disease flows without sharp manifestations, in the hidden
form. Patients marked weakness, fatigue, sometimes increase in temperature
Body to 37.0 - 37.5°WITH. In the urine detected in an increased number of leukocytes
and bacteria.
The disease can proceed with an increase in blood pressure, the so-called
Hypertensive form of the disease. Young patients suffer from headaches,
take in connection with this different kind of painkillers, and the presence of arterial
hypertension is often found randomly, further examination leads to
Identify chronic pyelonephritis.
Still distinguished the anemic form of the disease, when the leading signs will be reduced
The number of erythrocytes and hemoglobin in the blood. Patients feel weakness, fatigue,
The appearance of shortness of breath is possible.
The main symptoms of the exacerbation of pyelonephritis are: temperature rise,
Pain in the lumbar region, more often one-sided, rapid, painful urination,
Unpleasant feeling when urination. Sometimes the exacerbation can only manifest
temperature rise to 37.0- 37.2°With after a cold illness, this temperature
tends to hold a long time.
Outside exacerbations, chronic pyelonephritis proceeds with very low symptoms,
But at this time there is an increase in renal failure.
There are cases when chronic pyelonephritis first manifest itself
- symptoms of chronic renal failure, in which the kidney is not able
Clean the blood from slag. The accumulation of slags in the blood leads to the poisoning of the body.
Starting care for patients with pyelonephritis, it is necessary to explain to him the essence of the disease
and tell about the factors contributing to its exacerbation. The patient must change
Lifestyle and related to your health.
Care for patients with exacerbation of the disease
Mode. The patient needs bed for 2-3 weeks. When a person is experiencing
pain, suffers from fever or weakness, beddown seems to him
natural, but when subscribing or the absence of symptoms keep young
Patient in bed is quite difficult, so it is necessary to conduct conversations, in
the time of which you need to explain that the kidneys are easier and better work when horizontal
body position that kidneys «Love» warm and that warm bed is one of the best
Treatments treatment.
The patient may experience frequent urge to urination and day, and at night, so
It is desirable that the Chamber or Room, where the patient is to be near
Toilet. It is necessary to offer a patient at night to use the vessel to avoid hypothermia.
It is necessary to air the room either in the absence of a patient, or heat
(during the cold season you need to cover and head). The room should be warm,
and the patient should be enough warmly dressed, necessarily in socks. When cooling,
Especially legs, the patient has urination.
Diet and drinking mode. Food with exacerbation of chronic pyelonephritis should be high-calorie,
Alcoholic beverages, sharp dishes, seasonings, spices, meat and fish are excluded
Soups, coffee, canned. All vegetables and fruits are allowed, in all cases recommended
Watermelons, Melon, Pumpkin, Grapes. With anemic form of chronic pyelonephritis
In the diet include fruits rich in iron and cobalt: strawberries, strawberries,
Apples, grenades. The patient may have boiled meat and fish, eggs, milk and milk
products. If the patient has no high blood pressure or obstacles
Normal urine outflow, reinforced drinking mode for warning
excessive urine concentrations and for washing urinary tract. Eating fluid
should be at least 2 l per day. The patient should take their mors, -
Especially good cranberry, t.To. It contains a substance that turns into
organism (in the liver) in hippuric acid, which suppresses vital activity
Bacteria in the urinary tract, - Broth of rosehip, compotes, tea, juices, mineral
Waters (Essentuki No. 20, Berezovskaya).
With hypertensive form of chronic pyelonephritis limit the salt intake
up to 6-8 g per day (salt has the ability to delay liquid in the body).
It is recommended to eat when cooking does not solit, but to give a value
Salt patient on hands so that he can escape the food. Forced
Restrictions are often hard to transfer patients, so it is necessary with great
patience to explain that these measures are part of the treatment that, «irritant»
kidney improper nutrition or eating more than put on, salt, we are not
We can achieve the element of the process, normalizing pressure, and therefore we will be steadily
bring the development of renal failure. At the same time you need to try
Diversify menus, make food high calorie and delicious.
Drug therapy. An antibiotic therapy is carried out by appointment of a doctor. She is held like
Rule for a long time - 1.5-2 months. Patient (especially when conducting treatment
at home) must clearly and correctly take appointed therapy, about side
phenomena caused by drugs, such as nausea, loss of appetite need immediately
report to the attending doctor who can replace drugs.
Control treatment. Treatment control is carried out constantly, every 7-10 days the patient gives the necessary,
Urine tests assigned to the attending physician. It is very important to prepare correctly
For the surcharge. First of all, it is necessary to produce the toilet outdoor genital
organs.
Sanitary processing rule for men. Patient must be charged
urine to process the head of the penis and the entrance to the urethra 0.05% chlorhexidine solution.
This drug is on sale in special plastic packaging with a nozzle.
Sanitary Processing Rules for Women. Patient performs
Morning wash with soap, pure diaper dries big and small sex
lips, after which it processes the region of large and small lips 0.05% solution of chlorhexidine
With the help of sterile wipes, moistened with solution, and then the area of urethra
using the attached to the pharmacy packaging nozzles. If patients cannot themselves
produce a toilet, a nurse or person comes to the rescue
This patient. When you knead a woman under it put the ship, the patient
spreads quite wide legs and helped produces a wash (in front
Back), and then processing with disinfectant solution (chlorhexidine). When collecting
urine vessel should be clean and dry. The first few drops patient must
allocate in the toilet or to the ship. When collecting the so-called medium portion in the toilet
More urine is allocated, about a third, then the collection is made,
The last third also needs to be highlighted in the toilet (or ship).
Patients with a hypertensive form of chronic pyelonephritis need to be measured
diuresis (the amount of urine allocated per day) and determine the hydrobalance (ratio
between dried liquid and selected urine per day). Patient pick up comfortable
For urination dishes. It is necessary to prepare a measuring glass or another dimensional
dishes. Measurement begin in the morning. At 6 am, the patient empties the blade
bubble. This urination is not taken into account when measuring. Then every time when
the patient wants to perseverate, he does it into the appropriate dishes and then urine
overflowing into a measuring glass to determine its volume. All urine allocated
the patient during the day is taken into account in the same way. Last dimension
will be produced in the morning of the new day, about 6 am. In parallel with that
There is a counting and recording of the adopted liquid. Need to take into account not only liquid
in pure form (tea, morse, compote), but also soup, fruit. 65-75% stand out normal
adopted liquid. Reduced these figures indicates a fluid delay in the body
and the development of edema and, on the contrary, when increasing - about excessive loss of fluid,
For example, when taking patients with diuretic drugs. Depending on the flow
Diseave Diseases and Data Required Appointed Drinking Mode. More often
Total calculation of the volume of the necessary fluid (with edema, high arterial pressure)
It is produced like this: the number of urine dedicated per day + 400 - 500 ml. Patient
with this form of chronic pyelonephritis blood pressure must be measured
in the morning and in the evening.
Care for patients in the remission stage (out of exacerbation)
Although the patient does not need constant bed mode, streamline mode
work and rest is still necessary. Sleep patient should be at least 8 hours.
The daily rest is important (let not every day), at least 30 - 40 minutes in the horizontal
Position. Work in cold premises, on the street (especially in the cold time
year), in the night shift, in hot shops, stuffy rooms, heavy physical
Loads are contraindicated in patients with chronic pyelonephritis. Changing work sometimes
Heavyly experienced by the patient, but close people are tactfully, but they must persistently
convince the need for the right choice, because the continuation of labor associated
with supercooling or large loads, will provoke the aggravation of the disease.
Planning your vacation days, vacation or weekends, the patient must
remember the risk of supercooling and large physical exertion.
Therefore, of course,
It is better to abandon the campaign on kayaks or from a tourist trip to the cold
weather! The patient needs to remember (or remind him) about the need for the right
Clothing selection: on season, especially this applies to young girls and young men who
shy to wear warm underwear, warm shoes. An important preventive measure
is good and timely outflow of urine. Often (especially in patients with schoolchildren,
Students) The artificial retention of urination is usually associated
with a false shame of more frequent visits to the toilet or some kind of specific situational
Problems. Trust conversation with a close person can be reduced to «No»
And this problem.
Stagnation of urine - the most serious risk factor of exacerbations. Once
In 6 months, the patient must visit the dentist, must be visited
ENT doctor and follow its recommendations for the prevention and treatment of diseases
Nasopalotka. The patient's diet out of exacerbation is not so suction, but sharp dishes
and spices should not be on the patient's table. Receiving fluid (except in cases
hypertensive, as mentioned above) should be quite large (not
less than 1.5 - 2 l per day). Kidneys should well «wash». In the period of remission
(weakening or temporary disappearance of symptoms of the disease) to the patient usually
Conduct intermittent supporting therapy for 3-6 months (as intended
doctor). It is also called anti-relapse. What does it mean? For 10 days
each month the patient must take one of the designated antibacterial
drugs, according to the list that the doctor gives. Every month a new one is accepted
medicine. In the intervals between taking antibacterial drugs Patient
Takes Herbrails (Lingonberry Sheet, Birch Kidneys, Field Hall, Tolokanyanka,
She is bearish ears, kidney tea) - every 10 days every decoction. For example, with 1
On July 10, Nitroxoline (antibacterial drug), from 11
On July 21, the decoction of birch kidney, from July 22 to July 31 - a lonely sheet, and from 1
On August 10 - Neversman (antibacterial drug) and t.D. Naturally,
As in the state of remission, the patient periodically donates control analyzes
urine. For clear execution of designated therapy, a self-control diary is well.
Currently, when conducting relevant therapy, proper behavior
In relation to his health, the disease forecast becomes favorable
- You can prevent the development of renal failure and create conditions for
Full life patient.
