In this PowerPoint you will find a general explanation of kidney surgeries its definition, causes, risk factors. And you will find a detailed description of the nurse role for the patient after the surgery.

1. NURSING CARE AFTER KIDNEY SURGERY

2. SUPERVISORS
PROF/ Eman Mahmoud
PROF/ Entsar Gad Elmoula
DR/ Thanaa Diab
SUPR/ Asmaa Abdelati

3. DONE BY
1
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‫اقالديوس‬ ‫فايز‬ ‫عطيه‬ ‫ابانوب‬
10
.
‫حسانين‬ ‫عطيتو‬ ‫حمدى‬ ‫احمد‬
19
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‫شحات‬ ‫احمد‬ ‫حمدى‬ ‫اسراء‬
2
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‫عبدالرضى‬ ‫فتحى‬ ‫عويس‬ ‫ابتسام‬
11
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‫حسين‬ ‫سعد‬ ‫خميس‬ ‫احمد‬
20
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‫محمد‬ ‫علي‬ ‫ربيع‬ ‫اسراء‬
3
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‫عبدالرحمن‬ ‫احمد‬ ‫يوسف‬ ‫ابتسام‬
12
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‫مجلى‬ ‫احمد‬ ‫شعبان‬ ‫احمد‬
21
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‫هارب‬ ‫اسماعيل‬ ‫زكريا‬ ‫اسراء‬
4
.
‫صادق‬ ‫محمد‬ ‫اشرف‬ ‫ابراهيم‬
13
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‫ابراهيم‬ ‫احمد‬ ‫صبحي‬ ‫احمد‬
22
.
‫خليل‬ ‫انور‬ ‫زكريا‬ ‫اسراء‬
5
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‫محمد‬ ‫حسن‬ ‫شاذلى‬ ‫ابوالحسن‬
14
.
‫محمد‬ ‫على‬ ‫الدين‬ ‫صالح‬ ‫احمد‬
23
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‫محمد‬ ‫سليم‬ ‫حسن‬ ‫سليم‬ ‫اسراء‬
6
.
‫احمد‬ ‫ابوالحسن‬ ‫ابوالحمد‬ ‫احمد‬
15
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‫عبدالرحيم‬ ‫ابراهيم‬ ‫طلعت‬ ‫احمد‬
24
.

4. 26
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‫على‬ ‫مصطفى‬ ‫كمال‬ ‫احمد‬
35
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‫امبارك‬ ‫عطاالمنان‬ ‫سيد‬ ‫اريج‬
44
.
‫محمود‬ ‫ابوالعطا‬ ‫عبدالصبور‬ ‫اسالم‬
27
.
‫على‬ ‫احمد‬ ‫محمد‬ ‫احمد‬
36
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‫اسماعيل‬ ‫سيد‬ ‫جبريل‬ ‫ازهار‬
45
.
‫محمود‬ ‫احمد‬ ‫عبدهللا‬ ‫اسالم‬
28
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‫صالح‬ ‫محمد‬ ‫علي‬ ‫محمود‬ ‫احمد‬
37
.
‫مصطفي‬ ‫الدسوقي‬ ‫ابراهيم‬ ‫اسامه‬
46
.
‫على‬ ‫اسالم‬
‫سطوحى‬ ‫احمد‬
29
.
‫حميد‬ ‫الوهاب‬ ‫عبد‬ ‫الدين‬ ‫نصر‬ ‫احمد‬
38
.
‫محمود‬ ‫محمد‬ ‫احمد‬ ‫اسامه‬
47
.
‫ناصر‬ ‫اسالم‬
‫محمد‬ ‫حمدان‬
30
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‫الدندراوى‬ ‫محمد‬ ‫يسرى‬ ‫احمد‬
39
.
‫محمود‬ ‫محمد‬ ‫عبدهللا‬ ‫اسامه‬
48
.
‫احمد‬ ‫اسماء‬
‫على‬ ‫حمدان‬
31
.
‫عمر‬ ‫شعبان‬ ‫يوسف‬ ‫احمد‬
40
.
‫عالم‬ ‫فهمي‬ ‫جمعه‬ ‫اسراء‬
49
.
‫الودود‬ ‫عبد‬ ‫عبدالرحمن‬ ‫احمد‬ ‫اسماء‬

5. OUTLINES
1. Introduction
2. Definition
3. What are the kidneys ?
4. What is the function of the kidneys ?
5. Indication of kidney surgery
6. Contraindications for kidney surgery
7. How to prepare for kidney surgery ?
8. What will happene during kidney surgery ? (in the operation room)
9. Risk after kidney surgery (complications)
10.Nursing care plan

6. INTRODUCTION
■ Kidney surgery is a major procedure that requires
proper post-operative care and follow up to ensure
recovery and prevent complications. The kidneys are vital
organs in the body responsible for filtering waste and
excess fluid from the blood. Kidney surgery is performed
for several indications including removal of kidney
stones, treatment of kidney tumors, or other disorders
affecting the kidneys.

7. DEFINITION
■ Surgery to remove a kidney or part of a kidney. In a partial
nephrectomy, part of one kidney or a tumor is removed, but not
an entire kidney. In a simple nephrectomy, one kidney is
removed. In a radical nephrectomy, an entire kidney, nearby
adrenal gland and lymph nodes, and other surrounding tissue
are removed

8. WHAT ARE THE KIDNEYS ?
• The kidneys are two reddish-brown bean-
shaped organs found in vertebrates. They
are located on the left and right in
the retroperitoneal space, and in adult
humans are about 12 centimetres
(4+1⁄2 inches) in length.
• They receive blood from the paired renal
arteries; blood exits into the paired renal
veins. Each kidney is attached to a ureter, a
tube that carries excreted urine to
the bladder.

9. WHAT IS THE FUNCTION OF THE
KIDNEYS ?
•The main role of the kidneys:
is maintaning homeostasis. They manage fluid levels,
electrolyte balance, and other factors that keep the
internal environment of the body consistent and
comfortable.

10. The kidneys are powerful chemical factories that perform the
following functions:
• remove waste products from the body
• remove drugs from the body
• balance the body's fluids
• release hormones that regulate blood pressure
• produce an active form of vitamin D that promotes strong, healthy
bones
• control the production of red blood cells

11. INDICATION OF KIDNEY SURGERY
The most common reasons for kidney surgery include:
• Kidney stones: Large stones may require surgical removal if they
do not pass on their own.
• Kidney tumors: Both benign and cancerous tumors are often
treated surgically through partial or complete kidney removal.
• Severe kidney damage or disease: Surgery may be needed in
some cases of kidney disease, infection, or injury.

12. CONTRAINDICATIONS FOR KIDNEY SURGERY
• Patients with bleeding disorders.
• Heart problems
• lung disease, or liver disease may not be good
candidates for kidney surgery due to health risks.
• In some cases, alternative non-surgical treatments are
recommended if possible. Lone functioning kidney:
Surgery cannot be performed if there is only one
functioning kidney.

13. HOW TO PREPARE FOR KIDNEY
SURGERY ?
• Preparation includes various tests like blood test, urine test,
imaging scans.
• The patient is advised to stop eating and drinking 6-8 hours
before surgery.
• Anesthesia is commonly general anesthesia.
• An IV tube will be inserted to provide fluids.
• Patient is asked to stop smoke 1-2 month before surgery.
• PT(prothrombin Time and Partial prothrombin Time ) monitoring
is done to assess bleeding risk.

14. WHAT WILL HAPPENE DURING KIDNEY
SURGERY ?
(IN THE OPERATION ROOM)
• Patient received anesthesia.
• A catheter is inserted into the bladder.
• Robotic arms or laparoscopic tools are inserted through
several small incisions.
• The surgeon visualizes the kidney and vasculature.
• The parts of kidney performed then are resected and
removed.
• Incisions are closed with staples or sutures.

15. RISK AFTER KIDNEY SURGERY
COMPLICATIONS
Like all surgeries, kidney surgery poses some risks, including:
• Infection: There is a small risk of surgical site infection or kidney
infection following the procedure.
• Blood clots: Blood clots in the legs (deep vein thrombosis) or lungs
(pulmonary embolism) can occur after any surgery. Blood thinners and
compression stockings are used to prevent clots.
• Bleeding: While rare, excessive bleeding can occur during or after the
surgery. Transfusions or repeat surgery may be needed in some cases.

16. • Damage to surrounding organs: There is a small risk of injury to
the pancreas, spleen, liver or bowel during kidney surgery.
• Kidney failure: In rare cases, the remaining part of the kidney
may be inadequate or fail following partial nephrectomy.
Dialysis may be required.

17. NURSING CARE PLAN

18. ASSESSMENT
• Assess the patient's vital signs, including blood pressure,
heart rate, respiratory rate, and temperature.
• Monitor the patient's pain level and location, as well as any
signs of bleeding or infection.
• Assess the patient's urinary output and monitor for any
signs of urinary obstruction or infection.
• Observe the patient's fluid and electrolyte balance, including
monitoring for signs of dehydration or fluid overload.

19. • Assess the patient's mobility and activity level, including any
restrictions on movement or exercise.
• Evaluate the patient's psychological and emotional state,
including any anxiety, depression, or other mental health
concerns.

20. Evaluation
Interventions
Goal
Nursing diagnosis
Patient is free form any
source of infection
Maintain a clean patient
environment, wear a mask
in patient's room if policy
indicates.
Follow strict hand washing
technique.
Limit the number and
duration of invasive devices.
Assess patient's mouth for
white lesions characteristic
of oral candidiasis.
Monitor vital signs and
assess wound and urinary
catheter sites regularly for
signs of infection.
The client will experience
no signs/symptoms of
infection
Risk for infection related
to
surgical incision and urinary
catheterization.

21. Nursing diagnosis Goal Interventions Evaluation
Risk of blood clot formation
(Deep venous thrombosis)
related to surgery
• Prevent blood clots
formation
• Prevent complications of
the blood clot
• Bed rest to prevent clot
dislodgment (movement)
• Elevate affected or both
legs
• Turn patient every 2 hours
• Range-of-motion exercises
to the unaffected leg
• Warm compresses to help
reduce swelling
• Monitor vital signs every 4-
6 hours
• Assess patient for
complications of Plmonary
embolism, such as
shortness of breath, chest
pain, cough, hemoptysis,
tachypnea, crackles,
tachycardia,and fever
The client will have no
complications and the
blood clot will dissolve

22. Nursing diagnosis Goals Interventions Evaluation
Risk of bleeding related to
the surgery
• The patient will take
measures to prevent
bleeding
• the patient will be able
to recognizes signs of
bleeding that need to be
reported immediately to a
healthcare professional.
• The patient will not
experience bleeding
• Educate the at-risk
patient about
precautionary measures
to prevent bleeding
• Administer blood
products if indicated
• Educate the patient
and family
members about signs of
bleeding that need to be
reported to a health care
provider.
• Instruct the patient to
observe skin and
mucous membranes for
oozing of blood.
• Instruct the patient to
avoid products that
contain aspirin or
NSAIDs
The patient won’t suffer
from bleeding and won’t
report any signs of
bleeding

23. Nursing diagnosis Goals Interventions Evaluation
Risk for Decreased
Cardiac Output related to
kidney failure
The client will maintain
cardiac output within the
client’s normal limits of
BP/heart rate /pulse
• Encourage the patient to
rest in bed
• Encourage the client to
perform relaxation
techniques
• Administer or restrict
fluids as indicated.
• Provide supplemental
oxygen if indicated.
• Administer medications
as indicated(dopamine)
• Prepare for/assist with
dialysis as necessary
The cardiac output is within
normal limits

24. Nursing diagnosis Goals Interventions Evaluation
Excess Fluid Volume
related to kidney failure
The client will have:
• Normal urinary output
• Stable weight
• Vital signs within the
client’s normal range
• Absence of edema
• restrict fluids as
indicated.
• Promote sodium and
fluid restriction as
indicated.
• Insert indwelling
catheter, as
indicated.
• Administer
medication as
indicated :
(diuretics/Vasodilato
rs(
• Prepare for dialysis
as indicated
The patient will have normal
fluid volume

25. Nursing diagnosis Goal Intervention Evaluation
Impaired urinary elimination
related to urinary
catheterization and
postoperative pain.
• The patient will use
techniques to prevent
retention/urinary infectio
n.
• The patient will identify
the cause of
incontinence.
• The patient will provide a
rationale for treatment.
• The patient will
understand
the condition.
• Encourage adequate fluid
fluid intake (2–4 L per
day), and limiting intake
during late evening and
at bedtime.
• Recommend good hand
washing and proper
perineal care.
• Promote continued
mobility
• Educate the patient
about the importance of
limiting the intake of
alcohol and caffeine.
• Catheterize as indicated
Patient verbalizs techniques
to prevent urinary infection
and retention .
Patient is able to properly
self-catheterize/clean
indwelling catheter .
Patient achieves a normal
elimination pattern normal
output.

26. Evaluation
Interventions
Goal
Nursing dignosis
Patient is relieved from pain
• Acknowledge and
accept the client’s
pain.
• Assess the patient’s
comfort level with
non-pharmacological
methods of pain relief
• Determine and
administer the
appropriate prescribed
analgesic.
• Consider PCA if the
patient is a candidate
• Perform nursing care
during the peak effect
of analgesics
• Reassess pain level
after 30 minutes of
interventions.
• Report maximum pain
relief/control
• Patient uses
pharmacological and
nonpharmacological
pain-relief strategies.
• Patient report
improvement in mood,
coping.
Acute pain related to
surgical incision and tissue
trauma.

27. Evaluation
Interventions
Goal
Nursing diagnosis
Fluid is controlled and
balanced
• Supply balanced
electrolyte IV solutions as
directed.
• Administer electrolyte
replacements as
prescribed.
• Monitor vital signs,
particularly the blood
pressure levels.
• Regularly check for the
patient’s level of
consciousness
• Educate the patient
about avoiding foods
high in sodium.
• Monitor input and
• Patient will maintain
normal electrolyte levels
(serum potassium,
sodium, calcium,
magnesium, and
phosphorus)
• Patient will maintain
normal fluid balance
• Patient will maintain
adequate hydration
• Patient will maintain
normal kidney function
Risk for fluid and electrolyte
imbalance related to
surgical stress and altered
kidney function.

28. Evaluation
Interventions
Goal
Nursing diagnosis
The patient ia able to
participate in activities of
daily living to the fullest
extent possible for their
condition.
• Assist patient with
muscle exercises as able
or when allowed out of
bed
• Present a safe
environment: bed rails
up, bed in a down
position, and important
items close by.
• Establish measures to
prevent skin breakdown
and thrombophlebitis
from prolonged
immobilit
• Execute passive or active
assistive ROM exercises
to all extremities.
• The patient will be able
to perform physical
activity independently
• The patient’s mobility will
increase
• The patient will have no
complications of
immobility
Risk for impaired mobility
related to surgical site pain
and postoperative
restrictions.

29. Evaluation
Interventions
Goal
Nursind diagnosis
Patient feels comfortable
and anxiety is releved
• Provide education
about anxiety
disorders.
• Administer anti-
anxiety drugs, as
ordered.
• Encourage relaxation
techniques such as
deep breathing.
• Educate the client on
the importance of
sleep hygiene and
reducing
environmental
stressors.
• Assist the client with
identifying and
challenging irrational
thoughts.
• The client will appear
relaxed and report
anxiety is reduced to a
manageable level.
• The client will be able to
verbalize snd express his
feelings
Anxiety related to surgery
and postoperative recovery.

30. RECOVERY
• Most people take 4 to 6 weeks to recover from kidney surgery.
• Moderate activity and light exercise can begin after 2-3 weeks.
• More strenuous activity should wait until 6 weeks after surgery.
• Drink plenty of water to flush the kidneys.
• Follow up with the surgeon for any suture removal and to check
on the remaining kidney.
• Most patients return to their normal daily activities and work
after 2 months.

31. RESOURCES
• Ruiz-Ortega M, Rayego-Mateos S, Lamas S, Ortiz A, Rodrigues-Diez
RR. Targeting the progression of chronic kidney disease. Nat. Rev.
Nephrol. 2020;16(5):269-88. DOI: 10.1038/s41581-019-0248-y
[ Links ]
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Transplantar ou não transplantar. Em: Pestana JOM, Freitas TVS,
Silva Junior HT, editores. Transplante renal: manual prático. São
Paulo: Livraria Balieiro; 2014. p. 3-15. [ Links ]
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