심화 해설
Clinical Judgment
This question assesses your understanding of prioritization and pregnancy complications. For a mother at 28 weeks of pregnancy with acute pyelonephritis, the most important nursing intervention is monitoring for signs of preterm labor. Pyelonephritis during pregnancy is a serious infection; the inflammatory response and bacterial toxins can trigger uterine contractions, significantly increasing the risk of preterm labor. Therefore, preventing and early detecting potentially life-threatening preterm labor is the top priority among all interventions.
Memory Tip
Remember Pyelonephritis in Pregnancy = Preterm labor Priority (the 3P rule). Pyelonephritis during pregnancy means preterm labor is the priority.
KR vs US
In Korea, while managing urinary tract infections during pregnancy, the risk of preterm labor is recognized. In the US NGN/CJMM, risk recognition and preventive monitoring are emphasized more systematically, training nurses to determine priorities by asking, "What is the most dangerous complication?"
임상 시나리오
Clinical Practice Guide
When caring for a patient with pyelonephritis during pregnancy, the following comprehensive approach is necessary.
1. Preterm labor monitoring: Regularly assess uterine contractions (frequency, intensity, duration), changes in vaginal discharge, and pelvic pressure.
2. Infection management: Administer prescribed antibiotics (generally cephalosporins) on time and evaluate their effectiveness.
3. Hydration: Encourage IV fluid administration and oral fluid intake to prevent dehydration and maintain renal perfusion, but watch for overhydration.
4. Pain management: Use pregnancy-safe analgesics (e.g., acetaminophen), and applying heat to the infected area is contraindicated.
Caution
In SATA (Select All That Apply) questions, although it may seem like "all interventions are important," the action that prevents the 'most dangerous' complication in the patient's current condition is always the top priority. "Increasing fluid intake" is a correct intervention, but it has a lower priority than preterm labor monitoring, which addresses an immediate life threat.
학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.