{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Episode 431: Oncologic Emergencies 101: Urinary Obstruction","description":" \u201cThink about all the important things our kidneys do for the body. Those things are compromised. If we have excess buildup of toxins and waste in the body, you\u2019re having problems with fluid reabsorption. Then you have also problems with electrolytes not being balanced. Then in turn, you have ongoing shutdown of systems. So the cardiopulmonary system gets compromise. Your circulatory system then gets compromised. And then all the things in the body that depend upon ongoing circulatory flow are then causing major resets in the system that need to be addressed,\u201d ONS member Brenda S. Nettles, DNP, MS, ACNP-BC, AOCNP, CNE, assistant professor at the Johns Hopkins School of Nursing and nurse practitioner at Johns Hopkins Hospital in Baltimore, MD, told Madeline Johnston, MSN, RN, OCN\u00ae, oncology clinical specialist at ONS, during a conversation about urinary obstructions. Music Credit: \u201cFireflies and Stardust\u201d by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 4, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center\u2019s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge relating to urinary obstruction as an oncologic emergency. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast\u2122 episodes: Oncologic Emergencies 101 series Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis Episode 394: Prostate Cancer Survivorship Considerations for Nurses Episode 390: Prostate Cancer Treatment Considerations for Nurses Episode 387: Prostate Cancer Screening, Early Detection, and Disparities ONS Voice articles: A Primer on Urothelial Cancer Oncology Urgent Care Provides the Right Place, Right Time, and Right Treatment for Patients Experiencing Cancer-Related Emergencies In the Event of an Oncologic Emergency, Make Sure You\u2019re Prepared to Deliver Compassionate, Life-Saving Care ONS book: Understanding and Managing Oncologic Emergencies: Traditional and Emerging ONS course: ONS Oncologic Emergencies\u2122 ONS Oncologic Emergencies Learning Library American Cancer Society anatomy galleries: Female Genitourinary System Male Genitourinary System To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode \u201cAs far as diagnoses go, I think that the ones that we see most common are impacted by the actual genitourinary system itself being impacted, so your patients with prostate cancer and patients with bladder cancer are definitely the ones that we see most often. But you\u2019ll see that it\u2019s also in individuals that have a diagnosis of either mucinous neoplasms or invasive peritoneal disease that invades all the cavities of the body\u2014and also your sarcomas, because they also will actually the involve different parts of the renal system as part of their spread pattern.\u201d TS 3:55 \u201cThe first thing you want to do is try to eliminate the causative factor. So what\u2019s causing the obstruction? If there\u2019s something that\u2019s limiting flow because of the compression from the outside of the ureter or compressing around the kidney itself that they can\u2019t drain adequately, then you can look at ways to manage that by inserting a nephrostomy tube into the kidney. You can also put in ureteral stents to help alleviate the pressure from drainage from the kidney to the ureter and into the bladder.\u201d TS 7:20 \u201cIt\u2019s very common when people have a partial obstruction to have still some degree of urinary output. But the key thing is looking at, over time, how that may change. So if they do develop some progressive symptoms of the flank pain, and then also renal function begins to get a little bit lower and lower over time. Hematuria or signs of infection\u2014those are again that next-level discussion that needs to be had about what gets evaluated next to confirm a possible obstruction.\u201d TS 10:00 \u201cThe biggest misconception, I believe, would be that you have time to figure it out. And the individual that already has immunocompromised states and also possible decline in baseline renal function have very low thresholds for us to really wait on these things too long. It\u2019s always better to err on the side of caution and do at least the due diligence of minimal evaluation by looking at the individual\u2019s vital signs and looking at their ability to still have urine output. Then if that\u2019s now compromised, work further into the process in a more timely manner.\u201d TS 13:47 \u201cIt\u2019s always good to have a refresher about how to manage different types of urinary diversion systems, so check with your facility in regards to what they carry for nephrostomy tube devices and the maintenance plans they have for those as far as frequency of flushing. So you can be a problem solver for your individual that has these diversion devices place for urinary obstructions.\u201d TS 16:19 ","author_name":"The ONS Podcast","author_url":"http:\/\/onsvoice.libsyn.com\/website","html":"