Medical-surgical Nursing Demystified

(^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.