need help with nursing dx on pt with bladder cancer and gross hematuria

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please help! I am a student nurse and I need to write a care plan for my pt who has turbt bladder cancer with gross hematuria. would he have impaired urinary elimination.... it is not retention.....please help!:(

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Specializes in Fall prevention.

Yes he would have risk for altered urinary elimination. Risk for Infection, Knowledge Deficit, Risk for alter body image, risk for injury, Fear and anxiety just to name a few. Hope this helps

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Specializes in med/surg, telemetry, IV therapy, mgmt.

there is a sticky thread on the general nursing student discussion forum with information on how to write a care plan

you need to follow the steps of the nursing process:

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
  2. determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
  3. planning (write measurable goals/outcomes and nursing interventions)
  4. implementation (initiate the care plan)
  5. evaluation (determine if goals/outcomes have been met)

before you can even begin determining this patient's problems (nursing diagnoses) you must do a thorough assessment which, for a nursing student consists of:

  • a physical assessment of the patient
  • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
  • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
  • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.

just as a detective does an investigation, sorts through the information he collects, lists his clues, and finally proves who did the crime, you have to do something very similar by using the nursing process. every nursing diagnosis has a set of symptoms called defining characteristics. you need a nursing diagnosis reference to help you diagnose. there are a number of ways to acquire this information.

i will help you choose nursing diagnoses for this patient, but only if you post the abnormal assessment information.

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Other area's that you could include depending on your clients circumstances in the care plan are ...

-High risk for urinary retention secondary to gross haematuria and clotting.

-If catheter is insitu, then risk of catheter blockage (should have a three way catheter for irrigation)

-Acute anemia secondary to haematuria

-High falls risk secondary to blood loss

-Pressure Area Risk secondary to immobility

-Psychosocial Complexities secondary to (the above)

-Pain management

-Implementing support services ie: Cancer Society and/or Pallative care team (depending on outcome of biobsy)

-Social Worker involvement if required

-Discharge Planning

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