Page 1863 - Saunders Comprehensive Review For NCLEX-RN

remove a stone; a large flank incision is required, and
the client may have a drain and indwelling bladder
catheter.
2. Nephrolithotomy is an incision into the kidney made
to remove a stone; a large flank incision is required,
and the client may have a nephrostomy tube and an
indwelling bladder catheter.
F. Partial or total nephrectomy
1. Performed for extensive kidney damage, renal
infection, severe obstruction from stones or tumors,
and prevention of stone recurrence

2. Monitor the incision, particularly if a drain is

in place, because it will drain large amounts of urine.

3. Protect the skin from urinary drainage,

changing dressings frequently if necessary; place an
ostomy pouch over the drain to protect the skin if
urinary drainage is excessive.
4. Monitor the nephrostomy tube, which may be
attached to a drainage bag, for a continuous flow of
urine.

5. Do not irrigate the nephrostomy or bladder

catheters unless specifically prescribed.

6. Encourage fluid intake to ensure a urine

output of 2500 to 3000 mL/day or more as prescribed.
XXII. Kidney Tumors
A. Description
1. Kidney tumors may be benign or malignant, bilateral
or unilateral.
2. Common sites of metastasis of malignant tumors
include bone, lungs, liver, spleen, and the other
kidney.
3. The exact cause of renal carcinoma is unknown.
B. Assessment
1. Dull flank pain
2. Palpable renal mass
3. Painless gross hematuria
C. Radical nephrectomy
1. Description
a. Surgical removal of the entire kidney,
adjacent adrenal gland, and renal
artery and vein
b. Radiation therapy and possibly
chemotherapy may follow radical

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