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Renal Cell Carcinoma, Holman, H. C., Williams, D., Johnson, J., Ball, B. S…
Renal Cell Carcinoma
Patient Education
educate patient about the surgical procedure if getting a nephrectomy
educate patient on signs and symptoms of infection
Educate patients on what their urine should look and smell like
Take all meds as prescribed
Tell the patient to stay hydrated and to drink plenty of water
Tell the patient to watch their sodium intake
Teach the patient how to take their blood pressure regularly
Teach the patient what a normal BP is and what to do if it is consistently elevated
Pathophysiology
most common type of kidney cancer and occurs as a result of impair cellular regulation
healthy kidney tissue is damaged and replaced by cancer cells, which then impairs urine elimination for that kidney
systemic effects are called paraneoplastic syndromes and include anemia, erythrocytosis, hypercalcemia, liver dysfunction, hormonal effects, increased sedimentation rate, and hypertension.
5 different types: clear cell, papillary cell, chromophobe cell, collecting duct carcinoma, and unclassified type
there are 4 different stages
the cancer usually spreads to the adrenal gland, liver, lungs, long bones or the other kidney
causes are unknown but risk is slightly higher for people who use tobacco or are exposed to cadmium or heavy metals, asbestos, benzene, and trichloroethylene. Men, people with obesity, HTN, and african americans are all also at higher risk.
Assessment
ask the patient about their age, known risk factors, weight loss, changes in urine color, abdominal or flank discomfort, and fever.
Ask about family history of cancer in the kidneys, bladder, ureter, prostate, uterus or ovary.
pts may have flank pain (dull and aching), blood in the urine, and kidney mass that can be palpated.
renal bruit may be auscultated
bloody urine is a late sign
inspect: skin for pallor, darkening of nipples, gynecomastia in men, muscle wasting, weakness, and weight loss.
Diagnostics
urinalysis, hematologic studies (H&H, calcium, ESR, ACTH, hCG, cortisol, renin, PTH), creatinine, BUN
CT scan, MRI, ultrasound or biposy
Interventions
nephrectomy when cancer is local
if cancer has metastasized nephrectomy followed by chemo is the usual treatment
microwave ablation
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute
References:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing: Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5