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Nephrectomy, Risk Factors: Cardiovascular disease Diabetes Goodpasture Syndrome Renal Artery Stenosis Hypertension Polycystic Kidney Disease Obesity Renal Disease Renal Tumor Polycystic Kidneys that are Bleeding or Severely Infected Massive Traumatic Injury to the Kidney Elective Removal of a Kidney from a Donor R/t Medical Dx: Nephrectomy, Possible Nursing Dx: Acute Pain r/t (specify e.g incisional pain) Anxiety r/t (specify e.g. surgical recovery, prognosis) Constipation r/t (anesthesia or pain meds) Impaired Urinary Elimination r/t loss of kidney Ineffective Breathing Pattern r/t location of surgical incision Risk for deficient Fluid Volume Risk for Infection Spiritual distress/ Grieving Imbalanced Nutrition R/t Nursing Interventions (T, I, C) : Monitor Kidney Function (C) I&O (I) Electrolyte Management (C) Disease Proccess Teaching (T) Help facilitate grieving process (T) Foster support and understanding (T) S&S of infection (T) Teach Asepsis (T) Nutritional Therapy (Decrease Sodium Intake) (C), Pathophysiology: Hypovolemia, Excessive diuresis, Hypoalbuminemia, Decreased cardiac output Anaphylaxis, Neurologic injury, Embolism, Renal artery thrombosis, Nephrotoxic injury, Drugs, Hemolytic blood transfusion reaction, Severe crush injury, Chemical exposure Interstitial nephritis, Allergies, Infections, Acute glomerulonephritis, Malignant hypertension, Spinal cord disease, Strictures, Trauma (back, pelvic) R/t Medical Dx: Nephrectomy, Possible Nursing Dx: Acute Pain r/t (specify e.g incisional pain) Anxiety r/t (specify e.g. surgical recovery, prognosis) Constipation r/t (anesthesia or pain meds) Impaired Urinary Elimination r/t loss of kidney Ineffective Breathing Pattern r/t location of surgical incision Risk for deficient Fluid Volume Risk for Infection Spiritual distress/ Grieving Imbalanced Nutrition R/t Medical Dx: Nephrectomy, Medical Dx: Nephrectomy R/t Signs & Symptoms: Decreased GFR Decreased libido Increased Urea Respiratory Changes ( dyspnea, Kussmaul breathing CNS Depression Renal osteodystrophy Osteomalacia Yellow-Gray discoloration of the skin Anemia hypothyriodism Depression, Medical Dx: Nephrectomy R/t Diagnostic Procedures & Medications: Cr/Cl, Serum Creatine Urine Albumin, GFR H&P, ID Precipitating Causes BUN, Serum Electrolytes UA, Renal Ultrasound, H&H CT or MRI, Retrograde Pyelogram Protein/Creatine Ratio, Medical Dx: Nephrectomy R/t Complications: Infection Bleeding (hemorrhage) Post-operative pneumonia Risk of kidney failure in a patient with impaired function or disease in the remaining kidney. Abdominal Distention, Dialysis Hypocalcemia, Stomatitis Edema, Hypertension, Hypervolemia