A+) 성인 케이스 신장세포암_영양 불균형, 비효과적인 말초 조직 관류의 위험(문헌고찰, 간호진단 4개, 간호과정 2개)

소개

간호진단
#1 식욕부진과 관련된 영양불균형
#2 출혈과 관련된 비효과적인 말초 조직 관류의 위험
#3 침습적 처치와 관련된 감염의 위험
#4 수술 후 통증과 관련된 활동 지속성 장애

목차

Ⅰ. 문헌고찰
1.정의 ················································································································
2.병태생리 ·······································································································
3.진단 ················································································································
4.임상증상 ·······································································································
5.치료 및 간호 ····························································································
6.참고문헌 ······································································································

Ⅱ. 간호사정
1.전반적인 건강상태 사정 ·········································································
2.진단검사 및 영상의학검사 ·····································································
3.약물정보 ·······································································································
4.치료계획 ······································································································
5.PBL ·················································································································

Ⅲ. 간호과정
1.간호진단 ·······································································································
2.간호목표 ·······································································································
3.간호계획 ·······································································································
4.간호수행 ·······································································································

Ⅳ. 참고문헌

본문내용

Ⅰ. 문헌고찰
* 질환명: Renal cell carcinoma(신장세포암)

1. 정의
신세포암은 세뇨관 상피세포, 특히 신장피질에 생기는 원발성 종양이다. 2017년에 발표된 중앙암등록본부 자료에 의하면 2015년 우리나라에서는 신장암은 남녀를 합쳐서 4,555건으로 전체 암 발생의 21%를 차지했고, 남녀의 성비는 2.3:1로 남자에게서 더 많이 발생하였다. 발생건수는 남자가 3,134건으로 남성의 암 중에서 10위를 차지하였고, 여자는 1,421건이었다. 남녀를 합쳐서 본 연령대별로는 50대가 27.7%로 가장 많고, 60대가 25.2%, 70대가 19.1%의 순이다. 신장암 전체 발생건수 4,555건 가운데 암종이 91%를 차지하였다. 암종 중에서는 신세포암이 89.4%로 가장 많고, 그 다음으로 편평세포암과 이행세포암이 0.7%를 차지하였다.

2. 병태생리
신장암은 피질이나 신배에서 생기는데 샘암종이 80%를 차지하며, 50~70대 남성에게 흔히 발생한다. 예후는 암의 단계와 진행정도에 따라 다르며 폐, 간, 긴뼈의 순으로 전이된다. 신장암의 원인은 불명확하나 가장 중요한 위험요인은 흡연이다. 또 다른 위험요인으로는 비만, 석면/카드뮴이나 휘발유 등의 물질 노출과 염료/고무제품/페인트, 가죽제품 등을 가공하는 직업요인이 관련이 있는 것으로 추정한다.

3. 진단
소변검사에서 적혈구가 검출될 수 있다. 혈액검사 결과 혈색소와 적혈구용적률 수치 감소, 고칼슘혈증, 적혈구침강속도 증가 등이 나타나며 부신피질자극호르몬, 융모생식샘자극호르몬, 부갑상샘자극호르몬 등이 증가한다. 조영제를 사용한 CT검사나 MRI검사를 통해 종양의 크기와 형태, 주변 구조의 윤곽을 더 자세히 볼 수 있다. 신동맥조영술은 수술 전 혈관상태를 확인하거나 수술을 할 수 없는 경우 신동맥색전술이 필요할 때 시행한다.

참고자료

· 유양숙, 권보은 외, 성인간호학 (상) 제 9판, 현문사
· 유양숙, 권보은 외, 성인간호학 (하) 제 9판, 현문사
· 최명애 이경숙 외, 보건의료인을 위한 병태생리학, 계축문화사
· 이은회 외 공저, 비판적 사고에 기반한 간호과정, 고문사
· 약학정보원 홈페이지, 「우루사정100mg」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=A11A0430A0174
· 약학정보원 홈페이지, 「고덱스캡슐」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=A11AJJJJJ0736
· 약학정보원 홈페이지, 「트라젠타정」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=2011091500001
· 약학정보원 홈페이지, 「메토파지엑스알서방정500mg」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=2m2xj0u3ouxbr
· 약학정보원 홈페이지, 「야마테탄주1g」 https://www.health.kr/searchDrug/result_drug.asp?drug_cd=A11ACCCCC0249
· 약학정보원 홈페이지, 「지씨웰빙아세트아미노펜주」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=2020021400008
· 약학정보원 홈페이지, 「신일트라마돌염산염주사액」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=A11A2070B0033
· 약학정보원 홈페이지, 「플라스마솔루션에이주」, https://www.health.kr/searchDrug/result_drug.asp?drug_cd=A11AEEEEE0208
· 대한진단검사의학회 홈페이지
· https://www.labtestsonline.co.kr/lm/analytes/lft.html
· 녹십자웰빙 홈페이지「지씨웰빙아세트아미노펜주」,
· https://www.greencrosswb.com/product/product_view.asp?seq=30