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NCP Tumor Wilms: Ni Nyoman Udiani, S.Kep.,Ns.,M.Kep
NCP Tumor Wilms: Ni Nyoman Udiani, S.Kep.,Ns.,M.Kep
WILMS
Ni Nyoman Udiani,
S.Kep.,Ns.,M.Kep
BATASAN :
Tumor ganas ginjal yang berasal dari jaringan embrional primitive di
ginjal
Sinonim :
Nephroblastoma
Embrioma Ginjal
Adenosarkoma Ginjal
Karsinosarkoma Ginjal
Tumor ganas campuran ginjal
SEJARAH TUMOR WILMS
1899 : - Penyakit ini di tulis secara lebih lengkap oleh
MAX WILMS.
- Pragnosa jelek hampir selalu fatal.
1938 : - LADD menganjurkan pembedahan → 25% dapat
disembuhkan.
1950 : Gross dan Neuhauser : Tumor ini Radiosensitif
Operasi + Radiasi → 47,3% sembuh.
1956 : Faber : Tumor sensitif terhadap Actinomycin D.
Operasi + Radiasi + Khemoterapi → 80 – 90% sembuh
1969 : Di Amerika dibentuk : National Wilms Tumor Study
(NWTS) group.
EPIDEMIOLOGI :
Amerika :
- Insiden TW : 7,8/1 juta populasi usia 1-14 tahun.
- Setiap tahun terdapat 500 penderita baru
- 77% usia penderita ≤ 5 th
- 90% usia penderita ≤ 7 th
- Penderita ♂∽♀
- Faktor Ras ⊝
- Faktor lingkungan ⊝
V Tumor bilateral.
TERAPI TUMOR WILMS :
1. Pembedahan :
Nephrektomi transperitoneal
Bila N ⊕ → Remove
Bila tumor besar atau operabilitasnya meragukan →
kemoterapi preoperatif → me ↓spillage intraoperatif
TERAPI TUMOR WILMS
Perform handwashing prior
giving care, utilize mask and gown when
needed, provide a private room, monitor
for any signs and symptoms of infection.
Prevent oral trauma.
Instruct the use of a soft-sponge
toothbrush or sponge toothette or gauze
when rinsing the mouth; instruct to avoid
foods which are hot, spicy, or high
in ascorbic acid (vitamin C); provide oral
hygiene 30 minutes prior or after meals;
instruct to refrain from eating or drinking
for 30 minutes after completion of oral
hygiene; and offer moist, soft, bland foods.
Prevent anxiety.
Have the parents to stay with the child or
encourage open visitation, provide a telephone
number to call for information; explain all
procedures and care in simple, direct, honest
terms and repeat as often as necessary;
reinforce physician information if needed and
provide specific information as needed; and
provide consistent nurse assignment with the
same personnel; encourage parents to
participate in care.
Prevent anxiety.
Have the parents to stay with the child or
encourage open visitation, provide a telephone
number to call for information; explain all
procedures and care in simple, direct, honest
terms and repeat as often as necessary;
reinforce physician information if needed and
provide specific information as needed; and
provide consistent nurse assignment with the
same personnel; encourage parents to
participate in care.
Prevent injury.
Avoid any palpation of abdominal mass; post
sign on bed stating not to palpate
preoperatively; assess incision site for
redness, swelling, drainage, intactness,
and healing and change dressing when soiled
or wet; assess oral and perineal area; and
encourage parents to appropriately dress
child based on weather conditions and to
refrain from participating on rough activities
or sports.
Evaluation
Goals are met as evidenced by: