Page 285 - 2021 IDMT Digital
P. 285
ACUTE PYELONEPHRITIS
Introduction:
• $FXWH S\HORQHSKULWLV LV DQ LQIHFWLRXV LQIODPPDWRU\ GLVHDVH LQYROYLQJ WKH NLGQH\
SDUHQFK\PD DQG UHQDO SHOYLV
• 0RVW FRPPRQ FDXVDWLYH DJHQWV LQFOXGH E coli Proteus Klebsiella Enterobacter DQG
Pseudomonas
• 7KH LQIHFWLRQ XVXDOO\ VSUHDGV IURP WKH ORZHU XULQDU\ WUDFW
Subjective:
• 6LJQV DQG 6\PSWRPV
o )HYHU
o )ODQN SDLQ
o ,UULWDWLYH YRLGLQJ V\PSWRPV
o 6KDNLQJ DQG FKLOOV
o $VVRFLDWHG QDXVHD DQG YRPLWLQJ DUH FRPPRQ
Objective:
• 3K\VLFDO ([DP
o )HYHU DQG WDFK\FDUGLD PD\ EH SUHVHQW
o &RVWRYHUWHEUDO DQJOH WHQGHUQHVV XVXDOO\ SURQRXQFHG
• 7RROV
o 8$ S\XULD EDFWHULXULD DQG YDU\LQJ GHJUHHV RI KHPDWXULD ZKLWH FHOO FDVWV PD\ EH
VHHQ
8ULQH FXOWXUH VKRXOG EH RUGHUHG WR GHWHUPLQH DQWLPLFURELDO VHQVLWLYLW\
o &%& ZLOO VKRZ OHXNRF\WRVLV DQG D OHIW VKLIW
Assessment:
• 'LIIHUHQWLDO
o $SSHQGLFLWLV SRVLWLYH KHHO WDS SHULWRQHDO VLJQV
o &KROHF\VWLWLV KLVWRU\ RI V\PSWRPV ZLWK HDWLQJ LQVLGLRXV RQVHW
o 'LYHUWLFXOLWLV //4 SDLQ ZLWK PRUH SURPLQHQW GLDUUKHD
o /RZHU OREH SQHXPRQLD IHYHU FRXJK FKLOOV
o $FXWH HSLGLG\PLWLV SDLQ LQ WKH HSLGLG\PLV
Plan:
• 0HGLFDWLRQV
o )OXRURTXLQRORQHV DUH ILUVW OLQH WUHDWPHQW
2UDO FLSURIOR[DFLQ RU OHYRIOR[DFLQ
• (YDFXDWH VLWH IRU DQ\ FRPSOLFDWLQJ IDFWRUV
o 6HYHUH XULQDU\ VLJQV DQG V\PSWRPV L H , LQDELOLW\ WR XULQDWH LQDELOLW\ WR WROHUDWH
SDLQ RU RUDO PHGLFDWLRQV LQWUDFWDEOH QDXVHD DQG YRPLWLQJ
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