bladder cancer

[SamanthaHope85]

hello all! im about ready to tear the pages out of my med-surg book!!!!

were doing a bulletin board in GU about the nursing interventions for someone with bladder cancer... pre and post op preferably ANYTHING will help at this point... can someone PLEASE push me in the right direction?? any help woudl be greatly appreciated... all that in my book is comfort measures... and we need more than that.... help... please...:bowingpur

[NurseyBaby'05, BSN, RN]

If you're doing a bulletin board, I suggest you pick one aspect and focus on it.

Here are some biggies:

-Pre-op Teaching

-Post-op Teaching

-Signs/symoptoms of Bladder CA

-Common post-op meds

As far as nursing interventions, follow Maslow's Heirarchy of Needs and select a few that would fit each need.

[Daytonite, BSN, RN]

suggest you look at the patient booklet for bladder cancer on the national cancer institute website: http://www.cancer.gov/. you will also find weblinks by doing a search for "bladder cancer" on the medline plus website: http://www.medlineplus.gov/. when you find the different surgeries for this, you can learn about the surgeries on this website: encyclopedia of surgery http://www.surgeryencyclopedia.com/index.html

[SamanthaHope85]

thank you! i talked to my instructor yesterday and she told us to focus on the complications post-op, and come up with interventions to prevent them.

thanks again!

[color=#ff409f]panic plays no part in the training of a nurse. ~elizabeth kenny

[Daytonite, BSN, RN]

you can only know the post op complications if you know the specific surgeries being done. they can be any of the following and there are basically two major sets of complications which i have highlighted for you:

• transurethral resection (tur) and fulguration
  • complications include hemorrhage, infection, urine retention, incontinence and impotence in men

  [*]segmental bladder resection (tumor removal along with some of the bladder tissue)

  [*]radical cystectomy (removal of the bladder, seminal vesicles and prostate in males along with the urethra and surrounding lymph nodes; removal of the bladder, uterus, ovaries, fallopian tubes and anterior lady parts in females along with the urethra and surrounding lymph nodes)

  [*]kock pouch (ureterostomy, nephrostomy, continent vesicostomy)

  [*]ileal bladder

  [*]ureterosigmoidostomy

  • complications of all the above (except the tur) include bleeding, hypotension, nerve injury to the genitofemoral or peroneal nerve, anuria, stenosis of the surgical stoma that is formed, uti, pouch leakage, electrolyte imbalances, ureteroileal junction stenosis, vascular compromise, loss of sexual or reproductive function, psychological problems relating to changes in body image

don't forget the complications of anesthesia! patients undergoing general anesthesia may experience these possible problems:

• breathing problems (atelectasis, hypoxia, pneumonia, pulmonary embolism)
  
• hypotension (shock, hemorrhage)
  
• thrombophlebitis in the lower extremity
  
• elevated or depressed temperature
  
• any number of problems with the incision/wound (dehiscence, evisceration, infection)
  
• fluid and electrolyte imbalances
  
• urinary retention
  
• constipation
  
• surgical pain
  
• nausea/vomiting (paralytic ileus)
  

complications of epidural anesthesia (which may be used for a tur) are:

• hypotension
  
• rash around the epidural injection site
  
• nausea and vomiting from the opiates administered
  
• pruritis of the face and neck caused by some epidural narcotics
  
• respiratory depression up to 24 hours after the epidural
  
• cerebrospinal fluid leakage and spinal headache from accidental dural puncture
  
• sensory problems in the lower extremities

[SamanthaHope85]

thank you!