Monday, February 26, 2024

Nursing Diagnosis For Bladder Cancer

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Magnetic Resonance Imaging Scan

Bladder Cancer Overview: types, pathophysiology, diagnosis, treatment | The Basics | Understanding

Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays.

MRI images are very useful in showing cancer that has spread outside of the bladder into nearby tissues or lymph nodes. A special MRI of the kidneys, ureters, and bladder, known as an MRI urogram, can be used instead of an IVP to look at the upper part of the urinary system.

Ongoing Screening And Prevention

Follow-up care consists of monitoring patients for recurrent or progressive disease while also evaluating for psychosocial effects such as fear of recurrence, anxiety, depression, financial difficulties, and physical and sexual functioning. Bladder cancer is the most expensive cancer to treat per capita from diagnosis to death because of extended surveillance, and patients may have significant financial implications. Strategies to address psychosocial concerns include support groups, behavior therapy, and referrals to social work, ostomy care services, sexual health, or financial counselors as appropriate.

Abnormal Substances In Urine

At times, abnormal urine contains substances that are not normally found inside blood vessels, and these signs can be used to detect the disease. Common examples are protein, glucose, and blood, which can be easily identified due to their different colors .

The nurse should also be aware that many other conditions can cause impairment in urinary elimination, including:

  • Urethral stricture

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Nursing Care Plan For Cancer 1

Nursing Diagnosis: Deficient Knowledge related to a new diagnosis of cancer as evidenced by the patients verbalization of I want to know more about my new diagnosis and care

Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of cancer and its management.

Prevention Of Prostate Cancer

Nursing Care Plan Risk for Urinary Retention

The following measures can help prevent or decrease the risk of developing prostate cancer.

  • Consume a healthy diet. A diet reduced in dairy and calcium, for example, may help minimize the risk of prostate cancer. The following foods may help reduce the risk of prostate cancer: broccoli, brussels sprouts, and kale, fish, soy, olive oil, which contains omega-3 fatty acids.
  • Choose healthy foods over supplements. To date, no studies reported a decreased risk of prostate cancer with supplement use. As an alternative, eat meals that are high in vitamins and minerals to keep the vitamin levels in check.
  • Exercise regularly. Exercise can also help the patient reduce weight, which is important because obesity has been linked to prostate cancer according to a 2016 study. Aim for 30 minutes of exercise most days of the week with the doctors consent.
  • Consult with the healthcare provider regarding the risk of developing prostate cancer. According to certain studies, 5-alpha reductase inhibitors such as finasteride and dutasteride may reduce the overall risk of prostate cancer. These medications are intended to prevent prostate enlargement and hair loss.

However, some evidence suggests that men who take these drugs may be at a higher risk of developing a more serious form of prostate cancer . Advise the patient to check with the doctor if he/she is concerned about the risk of developing prostate cancer.

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Signs And Symptoms Of Prostate Cancer

Because some types of prostate cancer are non-aggressive, the patient may experience no symptoms. Advanced prostate cancer, on the other hand, frequently creates symptoms. Furthermore, other illnesses, such as benign prostatic hyperplasia , might mimic the symptoms of prostate cancer, so the patient will need to consult the doctor to get a proper diagnosis. Urinary difficulties, sexual problems, as well as discomfort, and numbness are all symptoms of prostate cancer.

  • Urinary issues. The prostate is placed beneath the bladder and it surrounds the urethra, therefore urinary issues are prevalent. Because of its location, a tumor on the prostate that gets large enough can press on the bladder or urethra, causing complications.
  • Sexual issues. Prostate cancer symptoms include erectile dysfunction. Often known as impotence, erectile dysfunction causes the patient to be unable to obtain and maintain an erection. Prostate cancer can also be indicated by blood in the sperm after ejaculation.
  • Numbness and pain. The patient may feel numbness or weakness in the legs and feet. If the cancer has spread and has put pressure on the spinal cord, the patient may lose control of the bladder and intestines.

Medical History And Physical Exam

Your doctor will want to get your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors and your family history.

A physical exam can provide information about possible signs of bladder cancer and other health problems. The doctor might do a digital rectal exam , during which a gloved, lubricated finger is put into your rectum. If you are a woman, the doctor might do a pelvic exam as well. During these exams, the doctor can sometimes feel a bladder tumor, determine its size, and feel if and how far it has spread.

If the doctor finds things that aren’t normal, you may to have lab tests done and you might be referred to a urologist for further tests and treatment.

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Treatment For Prostate Cancer

Based on the age, health status, and cancer stage, the doctor will establish a suitable treatment strategy to treat and control prostate cancer:

  • Nonaggressive

If the cancer is non-aggressive, the doctor may propose active surveillance, often known as careful waiting. If the doctor decides to use active surveillance to monitor cancer, they will assess the PSA every six months and perform an annual DRE. They may also repeat the biopsy and imaging 1 to 3 years following the first diagnosis.

When just observing the disease, the doctor actively observes the symptoms to see if treatment is required.

  • Aggressive

More aggressive cancers may be treated with different methods, such as:

  • surgery
  • radiosurgery with stereotactic accuracy
  • immunotherapy

Doctors use risk categories to guide the therapy if the prostate cancer has not advanced to stage 1-3. Advanced phases, on the other hand, may require more or less treatment. Other factors, such as age and overall health, may also play a role. Chemotherapy is performed after hormonal therapy has failed to address the condition.

Prostate Cancer Nursing Care Plans Diagnosis And Interventions

Bladder Cancer – Overview (types, pathophysiology, diagnosis, treatment)

Prostate Cancer NCLEX Review and Nursing Care Plans

Prostate cancer is the most often diagnosed cancer in men around the world. The American Cancer Society predicts that 268,490 men in the United States will be newly diagnosed with prostate cancer in 2022.

The prostate is a tiny gland that lies behind the bladder and surrounds the urethra in a mans lower abdomen and is controlled by the hormone testosterone.

The prostate gland also generates seminal fluid, also called semen. The sperm-containing substance that escapes the urethra during ejaculation is known as sperm.

Prostate cancer occurs when an abnormal, malignant growth of cells, known as a tumor, arises in the prostate. As the disease progresses, these tumor cells have the potential to spread to other parts of the body.

Because the cancer is made up of prostate cells in these circumstances, it is still called prostate cancer.

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Nursing Diagnosis Prostate Cancer

Impaired Urinary Elimination

Nursing Diagnosis: Impaired Urinary Elimination related to mechanical obstruction , catheter/balloon pressure and irritation, loss of bladder tone due to preoperative overdistension or prolonged decompression secondary to prostate cancer as evidenced by urgency, hesitation, dysuria, incontinence, retention, suprapubic soreness, and bladder fullness

Desired Outcomes:

Transurethral Resection Of Bladder Tumor

If an abnormal area is seen during a cystoscopy, it needs to be biopsied to see if it’s cancer. A biopsy is when tiny pieces of the abnormal-looking tissue are taken out and tested for cancer cells. If bladder cancer is suspected, a biopsy is needed to be sure of the diagnosis.

The procedure used to biopsy an abnormal area is a transurethral resection of bladder tumor , also known as just a transurethral resection . During this procedure, the doctor removes the tumor and some of the bladder muscle around the tumor. The removed samples are then sent to a lab to look for cancer. If cancer is found, testing can also show if it has invaded the muscle layer of the bladder wall. For more on how this procedure is done, see Bladder Cancer Surgery.

Bladder cancer can sometimes start in more than one area of the bladder . Because of this, the doctor may take samples from many different parts of the bladder, especially if cancer is strongly suspected but no tumor can be seen. Salt water washings of the inside the bladder may also be collected and tested for cancer cells.

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Nursing Care Plan For Cancer 2

  • Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to abdominal pain and cramping secondary to cancer, as evidenced by abdominal cramping, stomach pain, bloating, weight loss, nausea and vomiting, and loss of appetite

Desired Outcome: The patient will be able to achieve weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

Nursing Management: Renal And Urologic Problems

Early signs of bladder cancer and how to minimise its risk
7cm found only in the kidney No
> 7cm found only in the kidney No
Tumor is any size and found only in the kidney One or more nearby lymph node No
Tumor is found in the main blood vessels of the kidney or in the layer of fatty tissue around the kidney Yes, regional lymph nodes No
IV Tumor invades beyond layer of fatty tissue around the kidney and may be found in the adrenal gland Yes, regional lymph nodes
Any type of nodal involvement Yes
Metastasis
0 Flat, noninvasive carcinoma , also known as flat carcinoma in situ . Cancer only growing in inner lining layer of the bladder No No
I Tumor has grown into the layer of connective tissue under the lining layer of the bladder No No
II Tumor has grown into the thick muscle layer of the bladder wall, but it has not passed completely through No No
III Tumor has grown into the layer of fatty tissue that surrounds the bladder. May have spread into prostate, uterus, or vagina, but not growing into pelvic or abdominal wall. No
Tumor has grown through the bladder wall and into the pelvic or abdominal wall. Yes

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Risk Factors Of Cancer

  • Age most people are diagnosed with cancer at age 65 or older, although cancer can be diagnosed at any age
  • Gender in general, there are more male cancer patients than females however, the cancer type can be a factor in relation to gender
  • Family history some types of cancer can be inherited
  • Lifestyle and habits frequent exposure to sun, drinking more than the recommended alcohol limit, smoking, unsafe sex, sedentary lifestyle, and other habits and lifestyle factors may predispose a person to cancer
  • Chronic health problems having ulcerative colitis, for instance, may increase the risk for developing colorectal cancer obesity can also contribute to the development of cancer
  • Environment second hand smoking greatly increases the risk for lung cancer

Causes Of Prostate Cancer

The cause of prostate cancer is unknown. Prostate cancer develops when cells in the prostate have DNA alterations, according to doctors. The alterations cause the cells to divide and expand more quickly than normal cells. Aberrant cells grow continuously and form a tumor, which can spread and invade neighboring tissue. Some aberrant cells can break away and spread to other places of the body .

Risk Factors to Prostate Cancer

Predisposing factors may increase the risk of developing prostate cancer.The risk factors for developing prostate cancer are as follows:

  • Old age. the risks of acquiring prostate cancer rise as the patient get older. It gets increasingly common beyond the age of 50.
  • Race. For unexplained causes, black men have a higher risk of prostate cancer than other races. Black males are also more likely to have aggressive or advanced prostate cancer.
  • Family background. A family history of prostate cancer increases ones risk. Furthermore, if the patient have a strong family history of breast cancer or a gene that raises the risk of breast cancer , the chances of developing prostate cancer are higher.
  • Obesity. Obese people may have a higher risk of prostate cancer than people who are regarded to be of normal weight, while studies have produced inconsistent results. Furthermore, this risk group is also prone to develop a more aggressive caner posttreatment.

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Risk For Altered Family Processes

Alteration in family processes may occur in patient with cancer because of the change ins roles individuals in a family may face during the disease process. It can be an actual nursing problem or a problem that is at risk for occurring. This is a nursing diagnosis that includes not only the patient, but also sometimes involve family members and significant others.

Assessment

Assessment of the Risk for Altered Family Processes usually reveals the following conditions present:

  • Change in communication patterns within the family
  • Varying roles performed by members of the family
  • Disrupted routines in the family
  • Diagnosis of cancer/terminal cancer
  • Potential loss of a loved one due to cancer.

Desired Outcomes

At the end of nursing interventions, the patient and/or significant other is expected to:

  • Verbalize feelings about changes in family processes
  • Participate in interventions to help resolve issues
  • Find meaning in the experience that the patient/SO is going through
  • Develop mechanisms needed for coping and adjusting to the current situation.

Nursing Care Plan For Prostate Cancer 3

VISE Project Vault: Bladder Cancer Diagnosis and Treatment

Nursing Diagnosis: Risk for Deficient Fluid Volume related to difficulty controlling bleeding, restricted intake preoperatively, post-obstructive diuresis, and vascular nature of surgical area secondary to prostate cancer.

Desired Outcomes:

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  • The patient will demonstrate adequate hydration as evidenced by stable vital signs, palpable peripheral pulses, excellent capillary refill, moist mucosal membranes, and urine output within the normal range.
  • The patient will demonstrate the absence of active bleeding.

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What Are Some Of The Risk Factors Associated With Bladder Cancer

Risk factors are traits and behaviours that increase the chances of getting a particular disease. There are several established risk factors that can increase the chances for developing bladder cancer:

  • Smoking: This is the strongest and consistent risk factor for developing bladder cancer. Smokers are four times more likely of getting bladder cancer than non-smokers.
  • Certain occupations: Exposures to certain organic chemicals called aromatic amines increase the chances of developing bladder cancer. Occupations that use these chemicals include those in the textile, dye, rubber, leather, printing and paint industries.
  • Chronic bladder problems: Long-term infections and need for catheters can predispose patients for developing bladder cancer.
  • Radiation exposure: Patients with a history of radiation delivery to the bladder area are also predisposed to developing bladder cancer.
  • Cyclophosphamide: This is a chemotherapy drug used to treat lymphoma, but also increases the risk for developing bleeding problems of the bladder and bladder cancer.

Nursing Considerations For Bladder Cancer Survivorship Care

Bladder cancer is the sixth most common cancer in the United States, with an estimated 83,730 adult diagnoses in 2021. Smoking is the greatest risk factor , followed by advancing age and sex . The incidence rate in White people is double that of Black people, but Black people are twice as likely to die from the disease.

The five-year survival rate among all patients with bladder cancer is 77%, but that varies with stage of diagnoses. Survival rates are 96% for earlier stages or superficial disease, 69% for nonmuscle-invasive bladder cancer , and 37% for muscle-invasive bladder cancer . Metastatic disease has a 6% five-year relative survival rate, underscoring the need for early diagnosis.

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Common Signs Of Cancer

  • A lump or thickening in the breast or testicles are indicative signs for further investigation.
  • A change in a wart or mole may be reflective of melanoma or squamous carcinoma.
  • A persistent skin sore that does not heal may be indicative of melanoma.
  • A change in bowel or bladder habits, such as constipation, chronic
  • diarrhea, abdominal pain, rectal or urinary bleeding indicating gastrointestinal cancer.
  • A persistent cough or coughing up blood, indicating bronchial tree damage.
  • Constant indigestion or trouble swallowing, are common signs of colon, stomach, or esophagus cancer.
  • Unexplained weight loss, as cancer cells use up the patient energy source without him/her knowing it.
  • Unusual bleeding or vaginal discharge may be signs of uterine, endometrial or cervical cancer.
  • Chronic fatigue, a symptom often accompanied by rapidly progressing cancers.

Due to the multiple health issues and problems that a patient with cancer may have in the duration of the disease, you may encounter the need to implement several nursing care plans. These nursing care plan may include but are not limited to:

  • Risk for/Fluid Volume Deficit

These nursing diagnoses are discussed in detail below.

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