Renal and urinary tract cancers b

Question 1

Renal Cancer

Answer 1

Most patients are over 50 years old
• Risk increased in men
• 10th most frequently seen cancer in Australia
aka Renal carcinoma, Renal cell carcinoma
Hypernephroma

Question 2

Renal Cancer

• Risk factors

Answer 2

cigarette smoking; first degree relatives; obesity; hypertension; exposure to asbestos, cadmium,
petroleum

Question 3

• Clinical manifestations

Answer 3

haematuria, flank pain and a
palpable mass in the flank or abdomen; weight loss,
fever, hypertension and anaemia
• 30% rate of metastases at time of diagnosis

Question 4

• Treatment

Answer 4

surgical – nephrectomy; radiation therapy;
cyroblation (freezing) and radiofrequency ablation
(heat); chemotherapy

Question 5

• Postoperative management & nursing care include

Answer 5

Potential haemorrhage and shock
• Potential abdominal distension and paralytic ileus
• Potential infection
• Potential thromboembolism

Question 6

Renal Cancer (Children)

Answer 6

Wilms’ tumour

Question 7

Wilms’ tumour

Answer 7

Accounts for 8% of childhood cancers
• Peak incidence at 2-3 years of age
• Occurs alone or as part of a syndrome (WAGR syndrome)

Question 8

Other renal disorders

Answer 8

Potential for fluid and electrolyte imbalances due to renal disorders
• Patient require astute assessment and close monitoring for signs of potential
problems
• Fluid intake & output record – key monitoring tool
• Patient weight – i.e. accurate daily weight
• May have restrictions on diet and fluid intake

Question 9

Kidney disorders

Answer 9

Nephrosclerosis
Primary glomerular
diseases
Polycystic kidney disease

Question 10

Nephrosclerosis and treatement

Answer 10

Hardening (sclerosis) of the arteries of
the kidney, due to prolonged
hypertension.
• Results in decreased blood flow to kidney
and patchy necrosis of renal
parenchyma; eventual fibrosis and
destruction of glomeruli.
• Treatment – aggressive antihypertensive
therapy.

Question 11

Primary glomerular

diseases

Answer 11

Acute nephritic syndrome –
• Chronic glomerulonephritis –
• Nephritic syndrome

Question 12

Acute nephritic syndrome

Answer 12

clinical

manifestation of glomerular inflammation.

Question 13

Chronic glomerulonephritis

Answer 13

chronic

inflammation of the glomerular capillaries.

Question 14

Nephritic syndrome

Answer 14

– type of renal failure
characterised by increased glomerular
permeability, manifested by massive
proteinuria (permeable to plasma protein).

Question 15

Polycystic kidney disease and signs

Answer 15

Genetic disorder.
• Numerous cysts in the kidneys –
filled with fluid, nephrons destroyed.
• Renal damage, reduced kidney
function leading to kidney failure.
• Growing cysts result in abdominal
fullness and flank pain

Question 16

Polycystic kidney disease treatment

Answer 16

BP control,
pain control, antibiotics for
infections, renal replacement
therapy when kidney fail.
• Genetic testing and counselling.

Question 17

Renal & Urinary System Medications

Answer 17

Diuretic agents –

Question 18

Diuretic agents

Answer 18

Increase urine volume
• Their action increases the amount of osmotically active substances
(usually sodium and chloride ions). This opposes water reabsorption and
increases urine volume.
• Clinically used to treat oedema and ascites, reduce hypertension.

Question 19

Various classes of drug for renal

Answer 19

work at a slightly different site in the nephron or
using a different mechanism.
• Loop diuretics
• Thiazide diuretics
• Potassium-sparing diuretics
• Osmotic diuretics
• Carbonic anhydrase inhibitors
• Combination potassium-sparing and hydrochlorothiazide diuretics

Question 20

Renal & Urinary System

Medication Considerations

Answer 20

• Antibiotics – treat urinary tract infections
• Bladder protectants
• Anticholinergics/antispasmodics
• Medications for Benign Prostatic Hyperplasia (BPH)