The nurse instructs a client with pyelonephritis to drink 3000ml of fluids per day

The nurse instructs a client with pyelonephritis to drink 3000ml of fluids per day. The nurse understands that the rationale for this intervention is:

The correct answer and explanation is:

Correct Answer:
The rationale for instructing a client with pyelonephritis to drink 3000 ml of fluids per day is to flush the urinary tract, promote urine flow, and help eliminate bacteria, thereby preventing further infection and kidney damage.

Explanation (300 words):

Pyelonephritis is a bacterial infection of the kidney and renal pelvis, often caused by bacteria ascending from the lower urinary tract. One of the main goals in managing this infection is to clear bacteria from the urinary system and prevent complications such as abscess formation or chronic kidney damage.

Increasing fluid intake to about 3000 ml (3 liters) per day helps achieve this by several mechanisms:

1. Flushing Out Bacteria:
   High fluid intake increases urine production (diuresis). As urine flow increases, it mechanically flushes bacteria and other pathogens from the urinary tract, reducing their ability to multiply and cause infection. This washout effect decreases bacterial load and supports antibiotic treatment.
2. Dilution of Urine:
   Drinking plenty of fluids dilutes the urine, which can help reduce irritation of the inflamed urinary tract tissues. Concentrated urine can be more irritating and promote bacterial growth.
3. Preventing Urinary Stasis:
   Adequate hydration prevents urine from becoming stagnant in the kidneys and bladder. Stagnant urine is a breeding ground for bacteria, increasing the risk of infection or reinfection.
4. Supporting Kidney Function:
   Kidneys require sufficient blood flow and hydration to maintain their filtration and excretion functions. Fluids help maintain adequate renal perfusion, promoting healing and preventing further injury.
5. Symptom Relief:
   Adequate hydration can help alleviate symptoms such as burning during urination and promote overall comfort.

It’s important to monitor the client for fluid balance, especially if there are underlying conditions such as heart failure or renal impairment that may limit fluid intake. But in typical cases of pyelonephritis, encouraging fluids is a fundamental nursing intervention to support recovery and prevent complications.