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10:55 - 11:05
ESPUN S5-2
(O)
PEDIATRIC PATIENT SHOWING BLEEDING AFTER RENAL PERCUTANEOUS
NEPHROLITHOTOMY
Sandra GONZALEZ CAÑAS, Anna BULLICH LLOSA, María MUÑOZ PÉREZ, Sofia BOSCH COLLETTE, Laura GARCIA
PORRAS, Esther FRANQUET BARNILS, Anna PALOMINO MARTÍNEZ and Maria Teresa ALONSO TORRES
Fundación Puigvert, Nursing, Barcelona, SPAIN
PURPOSE
Renal bleeding is one of the most serious postoperative complications after a percutaneous nephrolithotomy (PNL).
Selective embolization is one of the treatments of choice to stop the bleeding. The role of the nurse in the early
detection of signs and symptoms of this complication is vital for the preservation of renal function. This study describes
the role of the nurse in the early detection of renal hemorrhage after PNL.
MATERIAL AND METHODS
A case study, 14 years old male with a history of repeated cystine calculi, recieving PNL performed in the left kidney,
after which he presented clinical symptoms of hematuria and hemodynamic instability. An angiography was performed
and it evidenced intrarenal pseudoaneurysm that was treated with selective embolization. An Individualized Care Plan
was applied
RESULTS
During late post-operatory period characteristic signs and symptoms of complications post PNL (moderate pain,
hematuria, nausea and vomiting) with hemodynamic stability was detected. 24 hours later the patient manifested
sudden hemodynamic instability (hypotension, diaphoresis, skin pallor and decreased hemoglobin).
CONCLUSIONS
The application of an individualized care plan and supervision and control of the signs and symptoms of renal bleeding in
the pediatric patient allows early detection of complications post PNL and promotes the satisfactory progress of the case.