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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
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
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)
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)
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)
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