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Discussion 4.1 – Case
Study One

The 56 year old African-American woman is admitted for
treatment of newly diagnosed renal cell carcinoma. You find her daughter in the hallway
crying. She has heard that her mother
has undergone genetic testing related to her cancer diagnosis and wonders if
she is at increased risk for the same condition. She was with her mother during the renal scan
before admission and is also worried that this exposure to a radioactive
isotope will cause cancer in her.

Is renal cell carcinoma commonly inherited, and why is
genetic testing done?

Do renal scan radioisotopes require radiation
precautions? Why or why not?

What risk factors are associated with renal cell carcinoma?

How can you evaluate whether your information was understood
by the daughter and if follow-up is needed?

Discussion 4.2 – Case
Study Two

At the start of the shift, you are assessing an 86 year old
patient who is awaiting surgery for a hip repair after a fall 12 hours ago at
home. You are collecting a clean catch
urine specimen, using a bedpan, as part of the preoperative preparation. You
observe that when she voids, the urine odor is foul and the urine is cloudy and
full of sediment. She reports some
urgency but notes that she had urgency before her fall.

What assessment information will you document in the chart?

What additional information should you ask the patient and
what else should you consider?

Organize your thoughts into SBAR communication

Who should you notify and why?

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