Open Nephrectomy

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Open Nephrectomy: Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. The procedure is done to treat kidney cancer as well as other kidney diseases and injuries. The surgeon makes a cut (incision) in the abdomen or in the side of the abdomen (flank area). A rib may need to be removed to perform the procedure. The ureter (the tube that carries urine from the kidney to the bladder) and the blood vessels are cut away from the kidney and the kidney is removed. The incision is then closed with stitches (National Kidney Foundation, 2015).
Nursing Considerations: Risk of Infection: Instruct to report signs and symptoms to the physician, including manifestations of infection (fever, general malaise, fatigue), redness,
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Prophylaxis and treatment of various thromboembolic disorders including: VTE, and PE. Prevention of thrombus formation. Nursing considerations: Assess for signs of bleeding (bleeding gums, nosebleed, unusual bleeding) or bruising. Instruct patient in correct technique for self infection, care and disposal of equipment *JL would most likely be going home on heparin injections so this is pertinent to him*

Hydrochlorothiazide 25mg PO: Antihypertensive, Diuretics. Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Lowering BP in hypertensive patients and diuresis with mobilization of edema. Nursing Considerations: Monitor BP, intake, output, and daily weight and assess legs, feet and sacral area for edema. Monitor electrolyte balances to assess hypokalemia.

Ramipril 10mg PO: Antihypertensive, ACE inhibitor.
Reduction of the risk of MI, stroke and death from cardiovascular disease in patients at risk. ACE inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also increase plasma renin levels and decrease aldosterone levels. Nursing Considerations: Monitor BP and pulse frequently. Assess patient for signs of angioedema. Monitor BUN, creatinine, and electrolyte levels
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