Subject

Adult Health Nursing I

Topic

Urinary Bladder And Renal Cell Carcinoma

Presented To: Madam Salma Shaheen
Presented By: Hina Rasool
Submission Date: ____________________
 TA B L E O F C O N T E N T S

Sr. No Contents Slide No

1 Introduction 3
2 Objectives 4
3 Anatomy of Urinary Bladder 5
4 Organs Associated with urinary bladder 6
5 Structure of urinary Bladder 7
6 Introduction of renal cell carcinoma 8
7 Definition of renal cell carcinoma 9
8 Causes of renal cell carcinoma 10
9 Pathophysiology of renal cell carcinoma 11
10 Manifestation of renal cell carcinoma 12
11 Diagnostic test for RCC 13
12 Medical nursing management 14
13 Surgical nursing management 15
14 Nursing Management 16
15 Nursing Process for RCC 17
16 Complications of RCC 18
17 Glossary 19
18 References 20
 FATIMA JINNAH MEDICAL COLLEGE

 PRESENTED TO:MAM SALMA

 PRESENTED BY:HINA RASOOL
 CLASS:BSN(BSN 2ND YEAR)
 TOPIC:URINARY BLADDER AND RCC
 At the end of this presentation the student will
be able to

 Introduce the urinary bladder its structure

and organs association.
OBJECTIVES  Define the renal cell carcinoma.
 Explain the causes pathophysiology,
manifestations and diagnostic testing.
 To implement the medical and surgical
nursing management.
 Understand the nursing process.
 Recognize the transitional cell and squamous
carcinoma of the urinary bladder.
ANATOMY OF URINARY BLADDER

• Urinary Bladder is a reservior for urine.It lies in the pelvic

cavity and its size and position vary,depending on the
volume of urine it contains.When distended the bladder
reaches into abdominal cavity.
 ORGANS ASSOCIATED WITH THE
BLADDER

 Anteriorly-Pubic Symphibisis
 Posteriorly-The rectum And Seminal Vesicles
 Superiorly-the Small Intestine
 Inferiorly-the Urethra and Prostate Gland
 STRUCTURE

 The bladder is roughly pear shaped, but becomes more

balloon shaped as it fills with urine. The posterior surface is base.
The bladder opens into the urethra as its lowest point the neck.
 The pentonium covers only the Superior surface before turns
upward as the parietal peritoneum lining the anterior abdominal
wall .Posteriorly it surrounds the uterus in the female and the
rectum in the male.The bladder wall is composed of three layers
 The outer layer of loose connective tissues containing blood and
lymph vessels and nerves.
 Middle layer consisting of interlacing smooth muscle fibers and
elastic tissue.
 Inner mucosa composed of transitional epithelium.
 RENAL CELL CARCINOMA

INTRODUCTION

 It's the most common type of kidney cancer. Although it’s a serious disease, finding and treating it early
makes it more likely that you’ll be cured. No matter when you’re diagnosed, you can do certain things to
ease your symptoms and feel better during your treatment.
 Most people who have renal cell carcinoma are older, usually between ages 50 and 70. It often starts as just
one tumor in a kidney, but sometimes it begins as several tumors, or it’s found in both kidneys at once. You
might also hear it called renal cell cancer.
 Doctors have different ways to treat renal cell carcinoma, and scientists are testing new ones, too. You’ll
want to learn as much about your disease as you can and work with your doctor so you can choose the best
treatment.
 DEFINITION OF RENAL CELL
CARCINOMA

1. Renal cell carcinoma is a type of kidney cancer that starts in the lining of very
small tubes (tubules) in the kidney.
2. The renal tubules filter the blood and produce urine. Also called
hypernephroma, renal cell adenocarcinoma, and renal cell cancer.
 CAUSES OF RENAL CELL CARCINOMA

The causes of renal cell carcinoma is unknown. However,

 A history of smoking does increase the risk for developing this disease.
 Patients with von Hippel-Lindau disease.
 Horseshoe kidneys.
 Adult polycystic kidney disease .
 kidney failure are also more prone to
 develop renal cell carcinoma.
 PATHOPHYSIOLOGY OF RENAL CELL
CARCINOMA

The two most common genes involved in the pathogenesis of RCC are the
 Von Hippel–Lindau ( VHL) gene
 The protein polybromo-1 ( PBRM-1) gene.
 The most common acquired risk factors for RCC are
 smoking,
 hypertension,
 obesity,
 chronic analgesic use
 diabetes
 MANIFESTATION OF RENAL CELL
CARCINOMA

 Blood in the urine (hematuria)

 Low back pain on one side (not caused by injury)
 A mass (lump) on the side or lower back.
 Fatigue (tiredness)
 Loss of appetite.
 Weight loss not caused by dieting.
 Fever that is not caused by an
 infection and that doesn't go away.
 DIAGNOSTIC TEST FOR RCC

 Complete blood count — a blood test conducted by

drawing blood from your arm and sending it to a lab
for evaluation.
 CT scan — an imaging test that allows your doctor
to take a closer look at your kidneys to
detect any abnormal growth.
 MEDICAL NURSING MANAGEMENT

 Radiofrequency ablation
 Chemotherapy
 Biological response modifiers
 tumor necrosis factor
 lengthen survival time
 Renal artery embolization
 SURGICAL NURSING MANAGEMENT

 Pre-op care
 Nephrectomy
 Post-op care
 Monitoring for hemorrhage
 Adrenal insufficiency
 Pain management
 Prevention of complications
 NURSING MANAGEMENT

Administer prescribed analgesics as needed by the patient.

Prepare for nephrectomy as indicated.
Provide symptomatic treatment for adverse effects of chemotherapeutic drugs.
Watch the patient for signs and symptoms of pulmonary, neurologic, and liver
dysfunction.
• Monitor laboratory test results for anemia, polycythemia, and abnormal blood
chemistry.
 NURSING PROCESS FOR RCC

Assesment Diagnosis Planning Implementation Evaluation

• Venous distension • Fluid volume • After 8 hours of • Record accurate Goal met,patient has
• Generalized excess nursing intake and output displayed
Edema • Compromised intervention • Weigh daily at appropriate urinary
• Patient reports of regulatory patient will same time of day output with specific
fatigue weakness mechanism display at same scale with gravity.
and malaise. appropriate same equipment
urinary output and clothing
with specific • Assess skin,face
gravity labartory and dependent
studies near areas of edema.
normal,stable,vita
l signs within
patient normal
range and absence
of edema.
 COMPLICATIONS OF RCC

 GENERAL
• Anorexia
• Diarrhea
• Edema
• Fatigue
 HAEMATOLOGIC
• Neutropenia
• Thrombocytopenia
 GLOSSARY

• Cryotherapy A method of killing cancer cells by freezing the tumour using a

probe through the skin to avoid open surgery.
• Fuhrman system A system used for grading renal cell cancer to indicate how
quickly or slowly the cancer is likely to grow and spread.
• Medical oncologist A doctor who specialises in the medical treatment of
cancer.
• Radiotherapy A treatment using high-energy rays to destroy cancer cells. It
can be used to shrink a kidney cancer and so control symptoms.
 REFERENCES

• Bruhnner & Suddarth’s textbook of medical-surgical nursing (10th ed.).

• Anatomy and physiology Ross & Wilson
THANK YOU