13. Bladder Cancer Case Study
Mr. G is a 55-year-old mechanic who has been healthy all his life until he passed some blood in his urine and saw a urologist at his wife's insistence. A urine specimen for cytology revealed atypical cells, and a diagnosis of bladder cancer was made following a cystoscopy with biopsy of bladder tissue. Intravesical therapy with bacilli Calmette-Guerin (BCG) is planned.
Subjective Data
• Has smoked a pack of cigarettes a day since he was a teenager.
• Says he dreads having the chemotherapy because he has heard cancer drugs cause such severe side effects.
Objective Data
• Cystoscopy and biopsy results: Moderately differentiated Jewett-Strong-Marshall stage A tumor on the left lateral bladder wall, with T2N0M0 pathologic stage; fulguration performed during cystoscopy
• Continues to have gross hematuria
Critical Thinking Questions
1. What does staging of bladder tumors indicate?
2. What information and instructions would the nurse provide for Mr. G. about his intravesical therapy?
3. How can Mr. G. help to prevent future bladder tumors from occurring?
4. How should the nurse explain the importance of follow-up cystoscopies?
5. What surgery might be indicated if the chemotherapy is not effective?
6. Based on the assessment data presented, write on or more appropriate nursing diagnoses. Are there any collaborative problems?