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  • NCP – Bladder Cancer Nursing Care Plan


    DEFINITION
    Bladder cancer is a cancer that starts in the bladder. The bladder is the body part that holds and releases urine. It is in the center of the lower belly area.
    The World Health Organization, In 2004, developed a new grading system for bladder cancer. This system divides bladder cancers into the following groups.
    • Urothelial papilloma – noncancerous (benign) tumor
    • Papillary urothelial neoplasm of low malignant potential (PUNLMP) – slow growing and unlikely to spread
    • Low-grade papillary urothelial carcinoma – slow growing and unlikely to spread
    • High-grade papillary urothelial carcinoma – more quickly growing and more likely to spread
    Symptoms include
    • Blood in your urine
    • A frequent urge to urinate
    • Pain when you urinate
    • Low back pain
    ASSESSMENT
    • Ask clients about changes in urination, note the color change, the frequency and amount of urine.
    • Hematuria with pain is the first sign of cancer blader, usually intermittent which often leads to barriers in the search for diagnostic services.
    • Due to disease progression, clients experience iritable bladder, with dysuria. Finally gross hematuria, obstruction or vistula encourage clients to seek treatment.
    NURSING DIAGNOSIS AND INTERVENTION
    1. Risk for injury related to radiation therapy and chemotherapy.
    Expected outcomes:
    • Clients do not develop problems associated with radiation therapy and chemotherapy
    Characterized by the absence of hemorrhagic cystitis.
    Intervention:
    • Giving anti-spasmodic.
    • Increased fluid intake.
    • Provision for cystitis urinary tract antiseptic.
    • Clients with proctitis, requires a low-fiber diet and agents to reduce intestinal motility.
    2. Knowledge Deficit related to diagnostic tests, surgery and urinary diversion.
    Expected outcomes:
    • Clients understand the diagnostic, surgical and treatment of urinary diversion.
    Characterized by client statement and demonstration of the ability to maintain.
    Intervention:
    • Prepare preoperatively, clients who experience urinary diversion.
    • Education about urinary diversion.
    • Encourage acceptance of the facts and results of urinary elimination through the skin of the rectum or stoma special.
    • Prepare general physical and emotional.
    • Note the gastrointestinal tract: non residue diet for a few days, intestinal sterilization, enema.
    • Advise clients to prevent skin contact with urine, to prevent skin irritation due to urinary diversion.
    • Clean the stoma with soap and water and then dried at any urine bag replacement.
    3. Impaired Urinary Elimination (dysuria) related to the tumor.
    Expected outcomes:
    • Clients will be diagnosed early to eliminate dysuria.
    Intervention:
    • Installation of indwelling catheters.
    • CBI to prevent blood clot
    • Intervention in TUR – P (input fluids, analgesics and antispasmodics as needed)
    4. Impaired Skin Integrity related to peristomal irritation.
    Expected outcomes:
    • Clients will not thrive on disruption of skin integrity, or peristomal irritation.
    Characterized by skin intact and clean
    Intervention:
    • Check the pH of the urine
    • Check the bag of urine to leak and whether the skin sensitive to the material.
    • Change bags for not leaking (too often replaced cause irritation).
    • During replaced bags allow contact with air as possible.
    • Give nystatin at around stoma.

    7 komentar:

    Anonim mengatakan...

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    Tara Omar mengatakan...

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    Celina Gomez mengatakan...

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