Name of Student: _Shaun Emmanuel P. Estremadura; Janelle G.

Etcubañas_ Section and Group: ____BN3G Group 2___

Name of CI: ___Ms. Kryssel D. Java RN, MN________ Area of Exposure: __Medical Ward 3__

Objectives: After 20 minutes of health teaching, the patient will be able to:

1. Discuss the concepts of renal cell carcinoma, its definition, risk factors, signs and symptoms, prescribed medications, treatments, and the different recommended interventions to the client.
2. Participate in the health teaching session and be able to answer different questions regarding the concepts discussed.
3. Perform the recommended activities including hygiene, exercise and diet to avoid complications and reemergence of RCC.

Medication Exercise Treatment Hygiene Outpatient Diet

Generic Name: ● Patients should Five types of standard ● Hand Washing - ● If you follow a few ● Limit food intake
Tacrolimus have aerobic and treatment are used: One of the best simple steps you can that are high in
Brand Name: strength ways to keep protect yourself from sodium,
Prograf exercises. ● Surgery - Surgery yourself from injury and infection: potassium,
to remove part or getting sick is to ● Use an electric razor phosphorus, and
C-(Classification) ● Maintaining all of the kidney is keep your hands instead of a blade limit fluid intake
Chemical class: macrolide physical strength often used to treat clean. You should when shaving to ● Sodium affects
Therapeutic class: Immunosuppressants is important while renal cell cancer. also encourage prevent nicks. blood pressure
undergoing renal The following friends and family ● Be careful when and helps
H- (How will you know the drug is cancer treatment types of surgery members to keep handling sharp items. maintain the
effective?) and a physical may be used: their hands clean. ● Wear gloves when water balance in
Drug is effective once it suppresses the body therapist will be gardening to protect your body. If there
of T cell transcription of NF-AT by binding the able to provide an ● Partial Chemotherapy and the your hands from cuts is excess sodium,
immunophilin FK-binding protein (FKBP). This exercise plan nephrectomy: A Mouth and scrapes. it will correlate to
enables the body to prevent organ rejection. specifically surgical procedure ● Use caution when fluid buildup in
designed for a to remove the ● Tongue: Your exercising to avoid the body. This can
E- (Exact time to be given) patient’s needs. cancer within the cancer medication grazing or scraping cause problems
Twice a day: 8 am & 8 pm kidney and some can reduce the your skin. such as swollen
● If a patient had of the tissue number of ● Use caution when ankles, high blood
C- (Client teaching – drug reaction) surgery to remove around it. A partial infection-fighting walking on wet or pressure,
● Take oral tacrolimus at the same time each the tumor, modest nephrectomy may cells in your blood slippery surfaces to shortness of
day with a glass of water; may be taken exercise can help be done to for a short period avoid falling and breath, and fluid
with or without food regain muscle prevent loss of of time, and during scraping your skin. buildup around
● Swallow tablet whole, do not crush, chew, tone and help to kidney function this time your ● Do not cut, tear, or the heart and
or break rebuild the when the other body’s ability to bite cuticles. lungs.
● Do not receive live vaccines muscles that were kidney is damaged combat infection ● Avoid manicures and ● Ways to cut
● Avoid drinking alcohol cut, increase that or has already may be lowered. pedicures. down sodium:
● Avoid eating or using grapefruit products patient’s range of been removed. Because of this, ● Do not squeeze or avoid table
as it may lead to unwanted side effects. motion, and help you are more likely scratch pimples. salt, cook at
● Avoid sunlight or tanning beds as using to prevent ● Simple to get an infection ● Wear clothing that is home, try new
this drug makes you more susceptible to complications that nephrectomy: A in the lining of your appropriate for the spices and
sunburns. Wear protective clothing and can occur surgical procedure mouth. The most type of activity you herbs instead
screen with SPF 30 or higher. post-surgery such to remove the common of these plan to do (for of salt, stay
as: respiratory kidney only. infections is a example, wearing away from
● Inform patient to speak with their doctor infection, pressure fungal infection long sleeves and packaged
before taking any other drugs/medications sores, and the ● Radical called thrush. gloves when foods, & read
as it may affect tacrolimus formation of a nephrectomy: A Thrush usually gardening). labels
● Inform patient or common side effects ie: deep vein surgical procedure appears as a white ● Having too much
shaking, headache, diarrhea, constipation, thrombosis (DVT). to remove the coating in the ● When to Call Your or too potassium
nausea, vomiting, upset stomach, stomach kidney, the mouth and on the Doctor or Nurse can cause muscle
pain, loss of appetite, trouble sleeping ● Exercise can have adrenal gland, tongue. ● Any time you change cramps, problems
(insomnia, or tingling or swelling of the the additional surrounding a bandage you with the way you
hands or feet. benefit of tissue, and, ● Gums: There are should check for heart beats, and
reducing stress usually, nearby times that the signs of infection. Call muscle weakness
K-(Keys to remember/ nursing and depression, lymph nodes. medicine you are the doctor or nurse if ● ex:Apples,
responsibilities/consideration which can be taking may cause you notice any of the cranberries,
● Be alert for new seizures or increase common Other treatments are: your gums to following: grapes,
seizure activity occurrences in ● Radiation therapy become sore and cauliflower,
● Be alert for signs of allergic reactions and patients ● Chemotherapy bleed. ● Drainage, especially if pital, white
anaphylaxis such as pulmonary symptoms undergoing ● Immunotherapy it is yellow in color breads, beef,
or skin reactions. cancer treatment. ● Targeted therapy ● Soft palate: ● Odor coming from chicken,
● Monitor signs of GI bleeding Because of your the wound whiterice
● Assess if there are any breathing ● Physical therapy medicine, your ● Redness in skin ● Avoid:
problems or signs of pulmonary can also be used mouth may become around the wound avocados,
dysfunction to combat fatigue, very sore, causing ● Swelling of the skin bananas,
● Asses vitals signs periodically which is not only small ulcers to around the wound oranges,
● Run lab test: monitor serum electrolytes, a common form. This soreness ● Pain or tenderness artichokes,
blood glucose, uric acid, BUN, and symptom of renal is called mucositis spinach,
creatine clearance periodically cancer but it can and can be very potatoes,
● Monitor kidney functions; report elevated be a side effect of painful. granola,
serum creatine or decreased urinary treatment (e.g. beans, brown
output chemotherapy). ● Mouth: Just as your or wild rice
Building up medicine may ● Too much
endurance can affect the lining of phosphorus in
Generic Name: reduce the the mouth, it can your blood can
Prednisone incidence and also have an lead to weak
Brand Name: severity of impact on the bones that can
Deltasone fatigue. This will glands that make break easily
be an important your saliva. This ● Ex: Italian,
C-(Classification) factor in can cause you to french, or
Chemical class: synthetic glucocorticoid increasing a have dry mouth. sourdough
Therapeutic class: corticosteroids patient’s bread, corn or
independence and ● If you do develop mice cereals,
H- (How will you know the drug is ability to maintain mouth sores, speak unsalted
effective?) a high quality of to your doctor popcorn
Patient should be able to experience less pain life. about whether to ● Avoid: Whole
and swelling. It will also help avoid organ substitute grain bread,
rejection after a kidney translation & should ● If you have RCC, mouthwash for salt Bran cereal and
lower the immune system’s response to the pace yourself or plain water oatmeals, Nuts
transplanted kidney. according to your mouth rinses, as and sunflower
E- (Exact time to be given) energy levels on this will cause less seeds, dark
Once a day; 8 am any given day discomfort. colored colas
C- (Client teaching – drug reaction) when you engage ● Due to damaged
● Must be taken with food or milk to prevent in physical ● Check with your kidneys, it cannot
upset stomach activity. doctor or nurse normally function
● Do not stop taking medication without before flossing your to get rid of the
consulting with your doctor ● Physical activity teeth because your extra fluids. Too
● Common symptoms that may be can help you chemotherapy may much fluid in the
experienced may be weakness, weight maintain your increase your body can cause
loss, nausea, muscle pain, headache, physical health chances of bleeding high blood
tiredness, & or dizziness; inform doctor if and at the same when you floss. pressure, swelling,
symptoms are persistent or worsen. time promote and heart failure.
● Avoid people who are sick, inform your positive mental ● Skin Changes, Skin It can also build
doctor if you have been around someone health, allowing Care and Bathing - up around the
who had chickenpox or measles. you a better A few changes to lungs making it
● Inform patient if they have the following outlook while your daily hygiene hard to breathe.
persistent side effects of confusion, managing renal routine as soon as ● Ways to quench
depression, DOB, or swallowing cell carcinoma. chemotherapy your thirst:
● Inform client to report unusual weight begins and Chew gum,
gain, swelling of the extremities, muscle throughout your rinse your
weakness, black or tarry stools, fever, treatment can help mouth, suck on
prolonged sore throat, colds or other to keep your skin a piece of ice,
infections, worsening of the disorder for healthy and lower mints, or har
which the drug is being taken your risk for candy
K-(Keys to remember/ nursing infection. An ● DASH Diet: stands
responsibilities/consideration important part of for Dietary
● Administer before 9am to mimic normal this routine is Approaches to
peak corticosteroid blood levels bathing. stop
● Dot not give live virus vaccine with Hypertension.
immunosuppressive doses of ● Skin Care and Rich in fruits,
corticosteroids Bathing veggies, low-fat
● Following the tips dairy products,
Generic Name: below will help whole grames,
Mycophenolate Mofetil protect your skin fish, poultry,
Brand Name: from damage and beans, seeds, and
CellCept, Myfortic, & MMF infection: nuts. Low in
C-(Classification) ● Bathe every day sodium sugars,
Chemical class: Reversible inhibitor of inosine and use warm fats, and red
monophosphate dehydrogenase (IMPDH) water. meats.
Therapeutic class: Immunosuppressive agent ● Avoid soaking in
spas or hot tubs.
H- (How will you know the drug is ● Use a mild soap for
effective?) bathing.
It is effective once MPA depletes guanosine ● Use a soft towel to
nucleotides preferentially in T and B gently wash skin.
lymphocytes and inhibits their proliferation,
thereby suppressing cell-mediated immune ● Be sure to clean
response and antibody formation feet, groin,
underarms, and
E- (Exact time to be given) other sweaty areas
Two times a day 8am- 8pm well.
C- (Client teaching – drug reaction) ● Do not rub skin
● Drug should be swallowed whole; do not with the towel,
break, crush, or chew. instead pat it dry.
● Should be taken at least 1 hour to 2 hours ● Do not share bath
after a meal or on an empty stomach towel with other
● Take drug at the same times each day family members.
● Following side effects may include ● Use unscented
drowsiness, confusion, dizziness, lotion or
lightheadedness, or cause uncontrollable moisturizing cream
shaking of a part of the body; do not drive on skin after it has
if this drug affects you. dried completely.
● Avoid taking OTC antacids simultaneously ● Protecting Skin
with mycophenolate mofetil. Take it after 2 From Cuts,
hours after taking the drug. Scrapes, Injury and
Infection
K-(Keys to remember/ nursing ● While you are
responsibilities/consideration going through
● Monitor Lab test to see if neutropenia chemotherapy, your
develops, withhold dose and notify body will not be
physician. able to fight germs
● Periodically monitor and report off as well as it
abnormalities for any of the following: normally would. At
Kidney and liver, serum, electrolytes, every step of your
lipase, and amylase; blood glucose; treatment, it is
routine urinalysis important to
● Monitor for and report any signs and protect yourself
symptoms of sepsis or infection. from getting an
infection. One of
the ways you can
Generic Name: do this is by
Misoprostol protecting your skin
Brand Name: from cuts and
Cytotec scrapes because
these are easy
C-(Classification) ways for germs to
Chemical class: Prostaglandin E1 enter your body.
Therapeutic class: Gastrointestinal agent

H- (How will you know the drug is

effective?)
Drug is effective once there is a significant
improvement in renal function as judged by
the lab results. Also when there is a reduction
in the incidence of acute rejection.

E- (Exact time to be given)

Twice a day 8am - 8pm

C- (Client teaching – drug reaction)

● Avoid using concurrent
magnesium-containing antacids
● If they have persistent side effects when
taking the drug, inform your doctor and
get medical help right away if
experiencing: severe abdominal pain,
severe diarrhea, signs of allergic reactions
like rash; hives; itching; red, swollen,
blistered, or peeling skin with or without
fever; wheezing; tightness in the chest or
throat; trouble breathing, swallowing, or
talking; unusual hoarseness; or swelling of
the mouth, face, lips, tongue, or throat.

K-(Keys to remember/ nursing

responsibilities/consideration
● Advise patient to avoid alcohol and foods
that may cause an increase in GI
irritation.
● Monitor for diarrhea; may be minimized
by giving drug after meals and at bedtime

Generic Name:
Warfarin sodium
Brand Name:
Coumadin

C-(Classification)
Chemical class: anticoagulant
Therapeutic class: blood thinners

H- (How will you know the drug is

effective?)
Drug is effective once there is a decrease in
clotting ability of the blood
E- (Exact time to be given)
Once a day at 8am
C- (Client teaching – drug reaction)
● Signs of unusual bleeding include; bleeding
of the gums, blood in the urine, bloody or
dark stool, a nose bleed, and or vomiting
of blood
● Inform healthcare provider if any of the
symptoms occur: severe headache,
confusion, weakness or numbness,
coughing up large amounts of bright red
blood, vomiting of blood, nonstop
bleeding, bright red blood in stool, fall or
injury to the head, and or severe or
unusual headache
● Ways to decrease the risk of bleeding; use
a soft=bristle toothbrush, floss with waxed
dental floss, shave with an electric razor
rather than a blade, take care when using
sharp objects, avoid activities that have a
risk of falling or injury
K-(Keys to remember/ nursing
responsibilities/consideration
● Measure the anticoagulant effect of
warfarin to see if it needs to be adjusted
later on
● Warfarin’s effect can be altered by a
sudden increase or decrease in body
weight
● Watch signs of bleeding and hemorrhage
● Caution patients to avoid IM injections
and activities that may lead to injuries

Generic Name:
Ibuprofen
Brand Name:
Motrin, Advil

C-(Classification)
Chemical class: nonsteroidal anti-inflammatory
drugs (NSAIDs)
Therapeutic class: NSAIDs
H- (How will you know the drug is
effective?)
Drug id=s effective once it blocks the body’s
production of certain natural substances that
cause inflammation; decrease in swelling, pain,
or fever

E- (Exact time to be given)

PRN every 4 hours
C- (Client teaching – drug reaction)
● Take with food or milk to lessen an upset
stomach
● Stop using and call your doctor if you have
the following symptoms of changes in
vision, shortness of breath, swelling or
rapid weight gain, skin rash, signs of
stomach bleeding. Low red blood cells,
kidney problems
● Common side effects may include nausea,
vomiting or gas, bleeding, dizziness, and or
headaches.
● Do not take more than 4 in 24 hours

K-(Keys to remember/ nursing

responsibilities/consideration
● Be aware if the patient may be at risk of
CV event, GI bleeding; monitor
accordingly
● Administer drugs with food or after meals
● Discontinue drug is eye changes,
symptoms of hepatic impairment, or renal
impairment occur