Medical-surgical Nursing Demystified

(Sean Pound) #1

(^378) Medical-Surgical Nursing Demystified
HALLMARK SIGNS AND SYMPTOMS



  • Fatigue—due to chronic process

  • Hematuria—blood in urine, may be microscopic

  • Change in urinary pattern—color, frequency, or amount of urine


INTERPRETING TEST RESULTS



  • Urinalysis shows red blood cells in urine.

  • Cystoscopy to identify tumor site and obtain biopsy.

  • Bladder biopsy shows cancer cell type.

  • CT scan shows metastasis or invasion of tumor.


TREATMENT



  • Surgical removal of tumor:

    • May be removal of superficial tumor from bladder wall with transurethral
      approach; removal of part or all of the bladder.

    • If all of the bladder is removed, a stoma is created on the surface of the
      abdomen or an ileal reservoir is created internally to collect the urine.



  • Instillation of BCG (bacilli Calmette-Guérin) into bladder to decrease chance
    of recurrence.

  • Radiation therapy.

  • Chemotherapy.


NURSING DIAGNOSIS



  • Risk of impaired urinary elimination

  • Disturbed body image

  • Fear

  • Powerlessness


NURSING INTERVENTIONS



  • Monitor vital signs.

  • Monitor intake and output:

    • Document amount and color of drainage from all drains.



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