Medical-surgical Nursing Demystified

CHAPTER 9 Genitourinary System^377

NURSING INTERVENTIONS

• Maintain the 3-port catheter postop. One port is for irrigation, another is for
  drainage, and the third to inflate a balloon that holds the catheter in position.


• Monitor intake and output.


• Monitor vital signs for changes.


• Monitor postoperative patient’s bladder irrigation:
  
  
  • Monitor the amount of fluid instilled and the amount of fluid returned and
    subtract the amount of fluid instilled from the amount returned to deter-
    mine the actual urine output.
  
  
  
  


• Document color of urinary output postoperatively; the greatest risk of hem-
  orrhage is the first day after the operation.


• Monitor for bladder spasms which may indicate blocked catheter drainage
  postoperatively.


• Teach patient:
  
  
  • Avoid caffeine, alcohol, decongestants, anticholinergics whichmay increase
    symptoms of BPH.
  
  
  • Proper home care of urinary catheter.
  
  
  • Monitor for signs of urinary tract infection.
  
  
  
  

Bladder Cancer

WHAT WENT WRONG?

Bladder cancer is typically a nonaggressive cancer that occurs in the transitional
cell layer of the bladder. It is recurrent in nature. Less frequently, bladder cancer is
found invading deeper layers of the bladder tissue. In these cases the cancer tends
to be more aggressive. Exposure to industrial chemicals (paints, textiles), history of
cyclophosphamide use, and smoking increase the risks for bladder cancer.

PROGNOSIS

The more aggressive the cancer cell type, the greater the risk of metastasis of the
disease. Patients may have advanced disease at the time of diagnosis. The more
advanced the disease at the time of diagnosis and the more aggressive the tumor,
the greater the risk of death for the patient.

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