Renal Cell Carcinoma

Question 1

Renal Cell Carcinoma - Pathophysiology

Answer 1

• almost always Adenocarcinoma kidney
• Replaces hlthy kidney tissue with cancerous tissue
  > impairs elimination
• Risk Factors:
  > gender; men > women
  > obesity
  > smoking
  > PKD
  > occupational chemicals: cadmium, heavy metals, asbestos, benzene, trichlorethylene

Question 2

Renal Cell Carcinoma - CMs

Answer 2

• Palpable abdominal/flank mass
• Painless hemturia
  > late sign
  > bright red flecks, clots, smoky or cola color
• Dull pain

Question 3

Renal Cell Carcinoma - Staging

Answer 3

Stage 1: tumors <7cm in largest dimension in kideny
> the renal vein, perinephric fat, & adjacent lymph nodes have no tumor
- Stage 2: tumors >7cm in largest dimension in kidney
> tumor remains in kideny, no lymph node involvement
- Stage 3: tumor has prenetrated major veins or perinehpric tissues, not beyond Gerota fascia
> tumor extend into lymph nodes but have distant metastasis
- Stage 4: tumors include invasion of adjacent organs beyond Gerota fascia or metastasis to distant tissues

Question 4

Renal Cell Carcinoma - Diagnostics

Answer 4

• Lab values
  > incrd BUN, Cr
  > urinalysis may show RBCs
• IV urography
  > like KUB
• Cryptoscopic examination
• Renal angiogram
  > shows blood vessels around kidney
• Ultrasonography
• CT scan
  > last 2 show growth/size
  Renal biopsy is biggest diagnostic

Question 5

Renal Cell Carcinoma - Medical Surgical Treatment

Answer 5

Goal: early tumor detection
- Pain management
- Surgery
> nephrectomy
- Chemotherapy
- Radiotherapy
- Palliation

Question 6

Renal Cell Carcinoma - Nursing Diagnosis

Answer 6

• Risk for postop bleeding
• Knowledge deifict
• Acute pain
• Risk for electrolyte disturbances
  > expected, going from 2 kidneys to 1
• Constipation

Question 7

Renal Cell Carcinoma - Nursing Interventions

Answer 7

• Postop assessment
  > vital signs!
• Incision care
• Line, tubes, drain care
• Monitor for infection
• Pain management
• I&Os/VS/Labs
• Pt education for discharge:
  > activity, lifting, driving
  > pain management
  > signs of infection
  > FU appts