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other urinary tract
disorders:
| Question | Answer |
|---|---|
| Renal Tumors | more common in men, primarily adenocarcinomas that develop unilaterally,first symptoms are often overlooked, usually rise from cells of the proximal convoluted tubules. |
| risk factors for renal tumors | smoking, family history of renal tumors, pre-existing renal disorders: polycycstic kidney, renal cystic diseas secondary to renal faillure |
| clinical manifestations. | painless, intermittent hematuria, weight loss, dull flank pain, palpable mass in the flank, metastatic related signs: resp distress, osteoalgia |
| Subjective Assessment; | hematuria which comes and goes with no associated pain, weight loss, fatique, dulll flank pain |
| objective data | palpable mass in flank hematuria, signs of metastasis |
| DX tests: | urinalysis revealing hematuria, IVP will detect renal mass, ultrasound will define composition of mass, other scans, MRI and renal arteriography may be performed |
| medical magm | Radical nephrectomy if disease is localized, radiation and chemotherapy provide minimal benefit |
| nursing interventions | care of post op nephrectomy pt, encourage pt to verbalizeconcerns r/t dx and prx |
| due to late diagnosis of this cancer many have poor prognosis upon diangosis | renal tumor |
| assist pt to identify what? | coping skills |
| support pt by doing what? | support realistic hope and answer questions honestly |
| pt teaching | instruct pt on community resources, support groups and home health services avail, understanding of the medication, assist pt to maintain physical activity, |
| how will a pt maintain physical activity | plan activities when pain is controlled, encourage ROM exercises, check for need of assistive devices |
| bladder tumors | range from benign papillomas to invasive carcinomas |
| most common site of cancer in urinary cancer? | bladder |
| Benign paillomas may become what? | cancerous then are removed |
| painless, intermittent hematuria, pt will seek what? | pt will often delay seeking treatment |
| subjective assessment, | changes in voiding paterns, signs of urinary obstruction or worsening renal failure, depending on extent of disease preocess |
| objective assessment | assess voiding patterns, urinalysis for hematuria, BUN, creatinine to assess renal function |
| dx test | KUB< ultrasound, IVP to identify mass, cystoscopy for cytological eval of mass, BUN, breatinine, other renal funciton tests |
| med mgm | local disease: fulguration (burning with an electric spark) laser ablation, chemotherapy instillation into bladder, radiation therapy |
| invasive lesions: | partial total cystectomy, requires urinary diversion |
| conduct cystoscopy with cytology eval freq, b/c the recurrence rate is what? | recurrence rate is up to 60% |
| Nursing interventions | care of pt dependent on extent of disease process, stress the importanct of f/u for papillomas and tumors has high recur, other similar to pt with renal tumors |
| polycystic kidney disease | genetic disorder characterized by the growth of multiple fluid-filled cysts which cn slowly replace much of the kidney, \ |
| renal function is compromised by | pressure of the cysts on kidney structures, secondary infections, tissue scarring caused by rupture of cysts |
| pt may progress to what? | end stage renal disease(chronic renal failure) |
| risk factors l | long standing renal insufficiency, dialysis pt |
| clinical manifestat9ions | symptoms influenced by thedegree of kidney structure involvement, |
| most common site of cyst formation is the collecting ducts: and what resulting complications occur? | collecting ducts fill with urine or blood, pt develops urinary obstrution, hydronephrosis or infection, renal function can slowly deteriorate |
| subjective assessment | abd and flank pain, h/a,gi c/o, voiding disturbances, hx of recurrent UTI |
| objective | htn, hematuria |
| dx tests | family hx and physical exam are critical to dx of polycystic kidney disease, exretory urography, radiographs and ultrasound to identify cysts, BUN, creatinine to monitor kidney function |
| med mgm | no specific tx for polycystic kidney desease, dialysis or renal transplant may be required |
| tx aimed at relief of pain symptoms of disease, | pain/hypertension control |
| heat and analgesics to relieve pain, but when should heat be discontinued | if bleeding occurs discontinue heat therapy and place pt on bedrest |
| htn control | antihypertensive agents, diuretics, fluid and dietary modifications |
| infection control | UTI common due to urinary stases, ABX freq admin |
| nursing interventions what dictates nursing interventions | pt complaints of severity of illness |
| Genetic counseling for family members and pt teaching about what? | encourage pt to discuss fears/ concerns regarding dx prognosis |
Created by:
redhawk101
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