Question

Write a Nursing care plan on the follownig care study using the rubric

  

case study: Management of Patients With Kidney Disorders

Dudley Wayne is a 62-year-old factory worker. Mr. Wayne makes an appointment with his primary care practitioner because he has lost 15 pounds in the last 2 months, and has recently noticed blood in his urine. He denies pain on urination. During the admission assessment, Mr. Wayne states that he is a two-pack-per-day smoker and just thought he was losing weight because of increased work stress. He also states that he worked 30 years in a building that was recently closed due to asbestosis contamination. Upon physical examination, Mr. Wayne complains of pain when the provider percusses and palpates his flank area. A CT scan is ordered along with an ultrasonogram; both reveal a mass in the renal pelvis. (Learning Objective

NURSING CARE PLAN RUBRIC

Do not write the NCP using a grid format… use an essay format/ bullet point using the numbers of this rubric.

All NCP will be graded according to the following rubric.

1) Definition of the medical diagnosis __________10

etiology/pathophysiology

2) Common signs and symptoms ___________5

3) Potential complications ___________5

4) Head to toe physical assessment you are to write one….use the data in the case if there is none you create it as if this was your patient. NOT a to do list!

__________10

5) Diagnostic and lab studies ___________5

normal values

expected abnormalities

6) ALL NANADA Nursing diagnoses __________10

7) Develop 3 NANDA priority nursing diagnoses __________10

8) State a patient plan AND goal for each of the __________10

priority nursing diagnosis

9) Write interventions for each of __________10

priority nursing diagnosis

10) Write scientific rationales for you you ___________5

interventions

11) Write evaluation of your interventions __________10

your plan or make changes

12) List of typical medications __________10

category

usual dosage

side effects

patient teaching

Answer 1

1) Renal pelvis is the part of the urinary system it originated in the middle part of the ureter. Urine is formed by the renal tubules and collected in the renal pelvis. It is made up of transitional cells any malignancy formation in renal pelvis is termed as transitional cell cancer.

The common etiology/ risk factor includes : family history of renal or bladder cancer, smoking , repeated urinary tract infections, continuous exposure to chemicals and pesticides that increases the risk of renal pelvis cancer.

2) The most common signs and symptoms are pain in the flank region, hematuria, drastic weight loss without any reason, fatigue, frequent urination.

3) The most common complications secondary to renal pelvis cancer are kidney failure ( repeated injury to the renal cells results in chronic degenerative changes ), hypertension ( disturbances in the ACE inhibitors),hypercalcemia, metastasis of cancer cells to adjacent structures.

4) History collection: past medical and surgical history, medications like excessive usage of Aspirin and NSAIDS. Smoking and alcoholic history, family history of renal cancer, occupational history to identify exposure to pesticides and chemicals.

Chief complaints: pain in flank region, sudden weight loss,general tiredness, blood in urine

General appearance: consciousness,oriented,localized pain

Vital signs Temperature, Pulse,Respiration - Normal. Blood pressure: 140/100 mmHg.

Abdominal examination: Inspection: guarding of abdominal region, icterus ,pallor. Auscultation: Bruit in the renal artery detected, Percussion: dull sound heard ,Palpation: rebound tenderness.

5) Diagnostic studies: urinalysis, urine culture to detect bacterial growth, urine cytology to detect cancer cells, Renal function test, Alkaline phosphatase an enzyme elevated during cancerous proliferation of cells, uroscopy, cystoscopy,renal biopsy, retrograde pyelography, ureteroscopy,bone scan,CT, scanMRI studies.