Retrograde pyelography is an invasive inspection of the kidneys from a distal way through the ureters (Chernecky and Berger 983). It has been used as a primary method infrequently, but it has a few probable signals when it can be a secondary method. Retrograde pyelography is mostly used to examine lacerations of the ureter. It generally necessitates a universal painkilling, and may end in the introduction of germs (Kumar and Clark 571).
The test can help discover what is the basis of the patient’s urinary issue. It can recognize obstacles such as tumors or tapering in the kidneys. It is habitually done if other examinations have been unconvincing. The test should expectantly give a better definition of the patient’s health problem so that the doctor could suggest appropriate treatment. The retrograde pyelography is normally done as a daytime procedure, with no overnight stay.
Antegrade pyelography is an invasive radiographic procedure in which radiocontrast substance is inserted percutaneously into the renal pelvis. The patient needed an antegrade pyelogram because other imaging examinations did not give the doctor enough evidence to reach a verdict (Chernecky and Berger 984).
The patient may have a blockage and the dye would not flow any further or may be deferred in the kidney. The antegrade pyelogram may also be used to evaluate the state of the patient’s kidneys. It can either prevent the surgical intervention or represent a follow-up procedure. In this case, the doctor may use a special pipe to pass the urinal flow around the obstruction or use a kidney pipe to release the blockage.
In this patient’s case, the retrograde and antegrade pyelography were required to detect and further examine hematuria. These two approaches are relatively helpful and were designed to assist in the projection and assessment of the urinary tract issues. The case showed that the procedures were carried out properly. Therefore, retrograde and antegrade pyelography helped to diagnose bladder tumor and the transitional cell carcinoma of the bladder (Kumar and Clark 572).
The medical worker should clarify the benefits and dangers of having retrograde pyelography, and correspondingly discuss the substitutes to the method. After that, the doctor will scrutinize the X-ray images to notice if there is any disruption in the flow. It is important to talk about the results of the patient’s test with him. The incidence of difficulties is subject to the exact type of procedure and patient’s general health. The doctor should also discuss the probable risks with the patient.
Cystoscopy is a type of examination that permits the doctor to look at the inner sides of the bladder using a thin tool termed a cystoscope (Gingell and Abrams 66). The cystoscope has been put into the patient’s urethra and gradually introduced into the bladder. Cystoscopy lets the doctor see the parts of the patient’s bladder and urethra that typically are not perceived well on X-rays. Miniature surgical utensils can be introduced via the cystoscope that let the doctor complete the tissue removal or get rid of the urine samples. Tiny tumors and bladder stones can be eliminated throughout the cystoscopy.
This may eradicate the necessity for more surgery, but it might be the reason of blood leavings in the patient’s urine. A grave flow of blood happens infrequently. The patient experienced abdominal ache and a burning feeling when emptying the bladder (Bickley, Szilagyi, and Bates 321). These indicators are normally insignificant and slowly fade after the cystoscopy. Hardly ever, cystoscopy can bring microbes into the patient’s urinary tract, producing a contamination. To avoid infection, the doctor might propose antibiotics to take prior to and subsequent to the patient’s cystoscopy. In this case study, the patient was exposed to the urinary tract infection, and his treatment should embrace numerous nursing interventions.
In the case of the serious pain correlated to the infection of the urethra, bladder, and other urinary tract functional parts, the goal is to decrease or dispose of the pain and control the contractions. The nurse should trace the urine dye color and patient’s pattern of bladder emptying (Jarvis 483). The nurse should also repeatedly analyze the outcomes of urinalysis. This should be done to recognize the signs of improvement or peculiar properties concerning the expected results. The nurse should apply measures, such as massage with the purpose of instigating relaxation and minimizing the patient’s muscle stiffness. Another option might be the introduction of perineal care in order to avoid infection of the urethra.
The patient should pay attention to the fun with the object of avoiding the feel of discomfort and pain. The patient might be introduced to the collaboration of pain relievers with the purpose of controlling the pain. In the end, the patient should report no discomfort on urination and no aching in the lower pelvic region (Reteguiz 332). If the case is the reduced urinary elimination linked to recurrent urination, perseverance, and diffidence, the goal would be to recover the voiding pattern. As a result, the patient should report a decrease in urination regularity. The intervention, in this case, should comprise the evaluation of the patient’s voiding pattern. It would be reasonable to reassure the patient to reduce water (or any other liquids) drinking after lunch.
The purpose of this approach is to maintain the renal blood stream and take out the germs from the urinary tract. The fluids that annoy the bladder should be evaded. This is done with the aim of not waking up regularly at night to void the bladder. An essential part of this approach is to motivate the patient to void the bladder every 2-4 hours (Reteguiz 332). The reason for this is the fact that it expressively reduces the number of germs in the urine and averts the reappearance of contamination.
Another issue that the patient may confront is the distressed sleep pattern associated with discomfort and nocturia. The nurse should recognize the typical sleeping behaviors in order to detect suitable interventions. Another strong point is to provide the patient with a cozy bed as it would capitalize on sleeping relief and support him both physically and emotionally. It is of the essence to diminish noise and light in order to create an atmosphere beneficial to sleep.
These measures should help encourage healthy and enjoyable sleep that has a great impact on the patient’s health (Reteguiz 332). The medical workers should pay attention to the hyperthermia consistent with the response to irritation. They should also react to any instance of amplified body temperature or the appearance of patient’s complaints. It is crucial to supervise the dynamic signs, specifically temperature, as designated so as to elaborate the interventions. The use of bandages (sprinkled with warm water) on the temple and both axillae is also defined as a way to rouse the hypothalamus. Antipyretic medications may also help in controlling fever.
Works Cited
Bickley, Lynn S., Peter G. Szilagyi, and Barbara Bates. Bates’ Guide to Physical Examination and History Taking. 11th ed. Philadelphia: Lippincott Williams & Wilkins, 2012. Print.
Chernecky, Cynthia C., and Barbara J. Berger. Laboratory Tests and Diagnostic Procedures. 6th ed. St. Louis: Saunders Elsevier, 2012. Print.
Gingell, Clive, and Paul Abrams. Controversies and Innovations in Urological Surgery. London: Springer, 2012. Print.
Jarvis, Carolyn. Physical Examination & Health Assessment. 7th ed. St. Louis: Saunders Elsevier, 2016. Print.
Kumar, Parveen J., and Michael L. Clark. Kumar & Clark’s Clinical Medicine. Edinburgh: Saunders/Elsevier, 2012. Print.
Reteguiz, Jo-Ann. Mastering the USMLE Step 2 CS (Clinical Skills Examination). 3rd ed. New York: McGraw-Hill, Medical Pub. Division, 2005. Print.