Progress : Painless hematuria, Flank pain, mass in the flank Weight loss, weakness, anemia It can spread to the lungs, bone, lymph, liver, or brain. Occasionally it does metastasize from the lung, the breast, melanoma, or malignant lymphoma Physical may be silent cancer Classic triad of symptoms in 10% of the cases mass in flank gross hematuria flank pain other symptoms: micro hematuria, fever, fatigue, and weight loss, anemias and polycythemias The Paraneoplastic syndrome is present if the tumors produce hormone or hormone like substances. Parathyroid hormone, hypercalcemia. Glucocorticoids hyperglycemia. The renal angiotensin system increase in blood pressure. Hematuria may be the initial sign or symptom for investigation. Diagnostic tests ultrasound CT scan IVP: intravenous pyelography MRI angiography systopic exam CXR Bone scan liver function if it's metastasized and evaluate if it is stage 1 to stage 4 Pain Ineffective airway clearance/breathing pattern Risk for infection Risk for impaired urinary elimination PC: Hemorrhage Outcomes verbalize a decrease in pain not develop respiratory complications not develop post-op infection Surgery: Nephrectomy following renal artery embolization: cuts off the blood supply to the tumor It causes tumor infarction and theoretically stimulates an immune response by triggering the release of tumor anti-agents to enhance the response Pre-op usual pre-op teaching: placement of incision and the importance and coughing in deep Post-op Post-infarction syndrome involves pain, fever, GI symptoms, and last several days Monitor complications: hemorrhage, monitor for respiratory problems due to flank incision, and possible paralytic ileus pain control drainage tubes and follies Chemo: renal cell carcinoma is refractory to most chemos which means it doesn't work, Radiation: especially if the candidate is not able to withstand surgery, so it's more palliative BRMs: Biological response modifiers like interleukin 2 and interferon
Cancer of the Bladder Nursing Assessment Nursing Diagnosis Treatment modalities Treatment modalities Bladder Cancer Bladder cancer is the most common site of urinary tract cancers, 90%. There is a 94 % survival rate if detected early. History Risk factors: things that have caused carcinogens to be in the urine or chronic bladder irritation Men are more likely, 4 to 1, than women whites are twice than blacks Over the age of 60 Cigarettes, exposure to dyes, solvents, UTIs, and parasitic infections A previous diagnosis of cancer can also be a risk factor because it may spread to the bladder from prostate, colon, rectum, or lower gynecological cancers in women dietary with the reduced intake of vegetables and fluids S/Sx Gross, painless hematuria UTI symptoms: urgency, frequency, and dysuria Pelvic or back pain with mets Physical No specific, except possible wt.
You've reached the end of your free preview.
Want to read all 11 pages?
- Fall '16
- Karen Price