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biggest risk factor bladder C

smoking (irritates bladder lining)

2 s/s bladder C

painless; intermittent gross/ microscopic hematuria

Dx bladder C

cystoscopy

4 Tx bladder C

surgery (removal of all/part; urinary diversion = urostomy); ileal conduit (bladder made from ileum, empty by stoma); increase fluids (2 - 3 L per day); change appliance in morning (lower output)

5 teachings re bladder C

may be impotent, note hourly I & O (look for changes), mucus production is normal, OK to use 4X4 during skin care for absorption (remember to remove it)

3 s/s prostate C

s/s of benign prostate hyperplasia (hesitancy, frequency, freq infections, nocturia, urgency, dribbling, or no s/s); painless hematuria; hard, nodular prostate w/ digital rectal exam

2 major Dx for prostate C

lab work, biopsy (to confirm)

3 lab tests prostate C

PSA (prostate specific antigen), alkaline phosphatase (increase means bone metastasis), acid phosphastase (increase means bone metastasis)

describe PSA test

blood test for protein from only prostate, normal = <4 ng/mL, start testing by age 45 if 2 or more 1st degree relatives with prostate C

5 prostate Tx

waiting (prostate C can be slow growing, wait to die from other diseases); SURGERY; radiation; chemo; hormone therapy

2 types surgery for prostate C

RADICAL PROSTATECTOMY for localized cancer (can be a cure, may cause erectile dysfunction, incontenence); PROSTATECTOMY (also transurethral resection of the prostate) - usually for helping urine flow with BPH

NCLEX rule for any implementation question

do assessment first

post surgery catheter caution

don't manually irrigate w/o physician order

long teaching list for prostatectomy post op

bleeding common; continuous bladder irrigation (maintains patency, flush clots, 3-way catheter, subtract irrigant from output), look for retention after catheter, temp incontinence (Kegel), avoid sitting, driving, exercise, lift >20 lb, straining (all to avoid bleeding)

3 types hormone therapy for prostate C

bilateral orchiectomy (decreased testosterone); estrogens; leuprolide (Lupron)

prostate C drugs for bladder spasm, straining

SPASM: belladonna & opium suppository (B&O suppository); STRAINING: docusate (Colace) to prevent bleeding

7 risk factors for stomach C

H-pylori infection, pernicious anemia, achlorhydria, some foods (pickled, salted, nitrates), tobacco, ETOH, Billroth II (partial gastrectomy w/ anastomosis)

2 common s/s for stomach C

heartburn, abd discomfort

less common s/s stomach C

loss appatite or wt, bloody stool, coffee-ground vomitus, jaundice (liver etastasis), epigastric & back pain, feeling full, anemia, + stool for occult blood, obstruction (abd distension, N/V, pain)

3 Dx for stomach C

upper GI, CT, EGD (esophagogastroduadenoscopy)

3 Tx stomach C

surgery (preferred = gastrectomy); chemo; radiation

2 major complications from gastrectomy

dumping syndrome; B-12 deficient anemia (pernicious anemia)

discuss B-12 problem with gastrectomy

no stomach = no intrinsic factor, can't absorb oral B-12, make poor RBCs, need IM B12 for life

2 nursing interventions for gastrectomy

use Fowlers position (low suture stress); use NG tube for decompression (not OK to reposition NG tube)

chemo drugs for stomach C

Fluorouracil (5-FU); Doxorubicin (Adriamycin); Mutamycin (Mitomycin-C); Cisplatin (Platinol-AQ)

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