Bladder cancer is a complex malignancy that requires comprehensive nursing care and management. This nursing diagnosis guide focuses on identifying key symptoms, implementing evidence-based interventions, and providing holistic care to patients with bladder cancer throughout their treatment journey.
Causes (Related to)
Bladder cancer development and progression can be influenced by various factors that nurses must consider when developing care plans:
- Primary risk factors:
- Smoking and tobacco use
- Chronic bladder inflammation
- Age (more common in older adults)
- Male gender (higher risk)
- Previous chemotherapy exposure
- Genetic predisposition
- Environmental factors:
- Exposure to industrial chemicals
- Chronic urinary tract infections
- Parasitic infections
- Radiation exposure to pelvis
- Occupational exposure to dyes and chemicals
Signs and Symptoms (As evidenced by)
Understanding the presenting symptoms is crucial for proper nursing assessment and care planning.
Subjective: (Patient reports)
- Painless hematuria (blood in urine)
- Urinary frequency and urgency
- Dysuria (painful urination)
- Lower back pain
- Pelvic discomfort
- Fatigue
- Weight loss
- Loss of appetite
Objective: (Nurse assesses)
- Visible blood in urine
- Changes in urination patterns
- Decreased hemoglobin levels
- Altered urinalysis results
- Presence of bladder masses
- Decreased BMI
- Signs of metastasis
- Compromised nutritional status
Expected Outcomes
Successful management of bladder cancer patients should result in:
- Patient will maintain optimal comfort level
- Patient will demonstrate understanding of disease process
- Patient will maintain adequate nutritional status
- Patient will show improved quality of life
- Patient will demonstrate proper self-care techniques
- Patient will maintain optimal urinary function
- Patient will experience minimal complications
- Patient will adhere to treatment protocol
Nursing Assessment
Monitor Physical Status
- Assess vital signs
- Monitor weight changes
- Evaluate nutritional intake
- Check for signs of infection
- Assess pain levels
Evaluate Urinary Function
- Monitor urination patterns
- Document characteristics of urine
- Assess for hematuria
- Monitor fluid balance
- Check for urinary obstruction
Assess Psychological Status
- Evaluate coping mechanisms
- Assess support system
- Monitor anxiety levels
- Check for depression signs
- Document body image concerns
Monitor Treatment Response
- Track chemotherapy effects
- Assess surgical site healing
- Monitor radiation side effects
- Document treatment adherence
- Evaluate symptom management
Review Risk Factors
- Document smoking history
- Assess occupational exposure
- Review family history
- Check previous treatments
- Monitor for complications
Nursing Care Plans
Nursing Care Plan 1: Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to disease process and treatment modalities as evidenced by verbal reports of pain, guarding behavior, and changes in vital signs.
Related Factors:
- Tumor growth and invasion
- Post-surgical complications
- Treatment side effects
- Inflammation
- Tissue damage
Nursing Interventions and Rationales:
- Assess pain characteristics regularly
Rationale: Enables proper pain management and intervention effectiveness - Administer prescribed pain medications
Rationale: Provides timely pain relief and prevents pain escalation - Implement non-pharmacological pain management
Rationale: Complements medication and promotes comfort
Desired Outcomes:
- Patient will report decreased pain levels
- Patient will demonstrate improved comfort
- Patient will maintain functional status
Nursing Care Plan 2: Risk for Infection
Nursing Diagnosis Statement:
Risk for Infection related to immunosuppression from treatment and invasive procedures as evidenced by decreased WBC count and presence of invasive devices.
Related Factors:
- Compromised immune system
- Chemotherapy effects
- Surgical interventions
- Urinary catheterization
- Malnutrition
Nursing Interventions and Rationales:
- Implement strict infection control measures
Rationale: Prevents opportunistic infections - Monitor for signs of infection
Rationale: Enables early detection and intervention - Educate about infection prevention
Rationale: Empowers patient in self-care
Desired Outcomes:
- Patient will remain free from infection
- Patient will demonstrate proper hygiene techniques
- Patient will maintain normal temperature
Nursing Care Plan 3: Impaired Urinary Elimination
Nursing Diagnosis Statement:
Impaired Urinary Elimination related to disease process and treatment effects as evidenced by frequency, urgency, and hematuria.
Related Factors:
- Tumor presence
- Bladder inflammation
- Treatment side effects
- Altered bladder function
- Surgical intervention
Nursing Interventions and Rationales:
- Monitor urinary patterns
Rationale: Identifies changes requiring intervention - Maintain catheter care if present
Rationale: Prevents complications and infection - Teach bladder training techniques
Rationale: Improves bladder control and function
Desired Outcomes:
- Patient will maintain normal urination patterns
- Patient will demonstrate proper catheter care
- Patient will report decreased urinary symptoms
Nursing Care Plan 4: Anxiety
Nursing Diagnosis Statement:
Anxiety related to diagnosis and treatment uncertainty as evidenced by expressed concerns, restlessness, and increased tension.
Related Factors:
- Disease progression
- Treatment outcomes
- Body image changes
- Financial concerns
- Family role changes
Nursing Interventions and Rationales:
- Provide emotional support
Rationale: Reduces anxiety and promotes coping - Teach relaxation techniques
Rationale: Helps manage stress and anxiety - Facilitate open communication
Rationale: Addresses concerns and provides reassurance
Desired Outcomes:
- Patient will demonstrate reduced anxiety
- Patient will utilize effective coping strategies
- Patient will verbalize understanding of care plan
Nursing Care Plan 5: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to treatment effects and limited mobility as evidenced by compromised tissue perfusion and pressure points.
Related Factors:
- Treatment side effects
- Nutritional deficits
- Decreased mobility
- Pressure points
- Radiation effects
Nursing Interventions and Rationales:
- Perform regular skin assessments
Rationale: Enables early detection of skin breakdown - Implement pressure relief measures
Rationale: Prevents pressure injuries - Maintain optimal nutrition
Rationale: Supports skin healing and integrity
Desired Outcomes:
- Patient will maintain intact skin
- Patient will demonstrate proper skin care
- Patient will identify signs of skin breakdown
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Jeong, C. W. (2018). Quality of Life in Bladder Cancer Patients. Bladder Cancer, 507-522. https://doi.org/10.1016/B978-0-12-809939-1.00028-X
- National Collaborating Centre for Cancer (UK). Bladder Cancer: Diagnosis and Management. London: National Institute for Health and Care Excellence (NICE); 2015 Feb. (NICE Guideline, No. 2.) 6, Managing locally advanced or metastatic bladder cancer. Available from: https://www.ncbi.nlm.nih.gov/books/NBK356292/
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
- Smith AB, Jaeger B, Pinheiro LC, Edwards LJ, Tan HJ, Nielsen ME, Reeve BB. Impact of bladder cancer on health-related quality of life. BJU Int. 2018 Apr;121(4):549-557. doi: 10.1111/bju.14047. Epub 2017 Nov 1. PMID: 28990272.
