15. Tumors arise from renal parenchyma in either central or
polar location
↓
Tumor may be a rim of compressed normal tissue
↓
Expanding mass surrounded by pseudo capsule of
connective tissue
↓
Appears to separate kidney tumor
↓
Tumor get encapsulated (thin& easily torn)
↓
Growth rapid
↓
Become
↓
Vascular, soft, gelations&necrotic in the center
16. Fever
Nausea
Loss of appetite
Short ness of breathing
Constipation
Without pain a mass in abdomen
Swelling or a hard mass in the abdomen
17. Medical History and physical
examination
Imaging test
Ultrasound (sono gram)
CTscan
MRIscan
Chest X-ray
Bone scan
Lab tests
Kidney biopsy
18. This system describes wilm’s tumor stages using Roman numbers
I to V
STAGE I:-
The tumor within the kidney and was completely removed by
surgery.
STAGE II:-
The tumor has grown beyond the kidney. About 20% of all wilms
tumors are stage-2.
STAGE III:-
The tumor has spread to lympnodes in the abdomen or pelvis.
STAGE IV:-
The cancer has spared through the blood to organs away from
the kidneys such has the LUNGS, LIVER, BRAIN or BONE, or to
LUMPH NODES four away from the body.
STAGE V:-
Tumors are found in both kidneys at stage V
19.
20. There are 3 types
1. Chemotherapy
2. Surgery
3. Radiation therapy
21. Under the chemo the drugs used for six months
The drugs are
Actinomycin-D
Vincristine
Doxorubicin
Cyclophosphamide
Carboplatin
22. Dose:- 15mg /kg daily by
intravenous route for 5days.
Action:- It is antibiotic
obtained from species of
Streptomyces.
It is very toxic and hence its
use is limited
23. Inhibition of mitotic spindles,
they are obtained from the
periwinkleplant, rosea, vinca.
Uses:-
Hodgkin’s disease and acute
lymphatic leukemia.
24. The drugs affect rapidly
growingcells and produce the
bonemarrow depression leading
to leucopnia, anemia and
thrombocytopenia
25. Hair loss
Mouth sores
Loss of appetite
Nausea and Vomiting
Diarrhea
31. Reduced kidney functions
Heart or lung problems
Slowed or delayed growth and
development
Increased risk of Second cancers
later in life
32. NURSING MANAGEMENT
NURSING DIAGNOSIS
Altered thermoregulation of body
temperature r/t to infections as evidenced
by checking vital signs.
GOAL
To reduced temperature
INTERVENTION
Provide comfortable position.
Assess the fever characteristics.
Provide cold compress of the body
33. In effective air way clearance related to
broncho spasm as evidenced by breath less
ness.
GOAL
To improve breathing pattern.
Intervention
Assess the breathing pattern
Provide the O2 inhalation or nebulization
Provide broncho dilators
34. Altered nutrition less than body requirements
related to anorexia as evidenced by weight loss.
GOAL
To improve nutritional status.
Intervention
Assess the nutritional status of the client
Monitor food intake not weight loss or weight
gain
Maintain favorable eating fluids as ordered
35. There is the remarkable correlation a
among the DNA content in the cells of
wilm’s tumor, histologic sub type, and
treatment out come. Stem lines of both
the primary tumor and Meta stases are in
the diploid and low aneploid (hyper
diploid) range
36. Introduction:-
Nephrotic syndrome is primary a
paediatric disorder and is 15 times more
common in children than adults.
Nephrotic syndrome is one of the
common cause of hospitalization among
children.
37. Definition:-
Nephrotic syndrome is a symptom complex
manifested by massive edema, hypoalbuminemia,
marked albuminuria and hyper-lipidemia.
“Parul data”.
Nephrotic syndrome refers to a kidney disorder
characterized by protenuria, hypoalbuminemia,
and edema.
“Jean weiler”.
38. The annual incidence of nephritic
syndrome in the united states in
children younger than 16years is 2
per 1,00,000 children (rother berg
and heymann.1957; Schlesinger,
1968, sultz,1972) and cumulative
prevalence is 16 per 1,00,000
children (Schlesinger,1968).
48. History of illness
Physical Examination
Laboratory investigations
Urine Examination
Blood examination
Renal biopsy
49. Albumin infusion (1gm/kg/day) may be
given in case of massive edema and
ascites.
Immunosuppressive drugs (levamisole,
methotrexate, Cyclophosphamide,
Cyclosporine, Chlorambucil)
Prednisone at a dose of 2mg/kg/day
Remission steroids
Initiative therapy
Cyclophosphamide or Chlorambucil
Cyclosporine
50. Frusemide-1to3mg/kg/day in divided
doses along with Spironolactone 2to
mg/kg/day in two divided doses is given.
Oral Penicilline
51. Nursing Diagnosis:-
Risk for impaired skin integrity rt to
edema and decreased circulation
Goal:-
To improved circulation
Interventions:-
Ensure that the child changes position
every 2 hours
Maintain good hygiene
52. Risk for infection rt to urinary loss of
gamma globulins and immune suppressive
therapy
Goal:-
To reduced infection
Interventions:-
Administered antibiotics as ordered
Monitor child for fever, cough, and sore
throat
53. Excess fluid volume rt to decreased
excretion of sodium and fluid retention
Goal:-
To decreased fluid volume
Interventions:-
Monitor intake and output each shift
Monitor blood pressure at least once each
shift
55. Calcium and vitamin-D Deficiency
Protein Energy malnutrition
Relapse of Nephrotic Syndrome
56. The majority of children with steroid-
responsive nephritic syndrome have
repeated relapse. Which generally
decreased in frequency as the child grows
order. Although there is no proven way to
predict an individual child’s course, those
children who respond to steroids rapidly
and those who have no relapse.
57. Over the past few decas, research in to wilm’s tumor has to
great advances and much higher cure rates for this type of
cancer. Still, not all children are cured, and even those who
are cured might still have long-term side effects from
treatment, so more research is needed.
Research is continuing to unravel how changes in certain
genes cause wilm’s tumors and affect how aggressive
tumors are likely to be.
Researches are also studying the gene changes that seem
to cause wilm’s tumor cells to grow and spread. This may
lead to treatments that specifically target these changes.
Research continues to study ways to improve treatment for
children with wilm’s tumors.
As researches have learned more about the gene changes
inwilms tumor cells. They have started to develop never
drugs that specifically target these changes.