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At the end of this session, you will be able to :
State the definition of cancer colon. List the etiology of cancer colon. Identify the pathophysiology of
cancer colon. State the sign & symptom of cancer
colon.
LEARNING OBJECTIVES cont.
Identify the complication of cancer colon.
Understand regarding treatment of cancer colon.
Identify the nursing intervention & appreciate the nursing care for cancer colon patient.
PATIENT’S PROFILE
MRS. T
FEMALE
54 YEARS OLD
HOUSEWIFE
PATIENT’S PROFILE WHEEL CHAIR
ANXIOUS
ALLERGICS - NIL
D.O.A 18/6/13 @ 1000 Hrs
Mrs T was admitted to 5XX-1 with complaint of intermittent constipation and loose stool with abdominal bloating and
discomfort X 1/12.
Doctor = Dr DB
Diagnosis - CANCER COLON
PATIENT’S PROFILE MEDICAL HISTORY Nil
SURGICAL HISTORY Right hemicolectomy (1/2007) at GH Kangar Colonoscopy (10/7/12) at KMC OGDS & Colonoscopy (21/6/11) at KMC
FAMILY MED HISTORY Unknown
CURRENT MEDICATION
Nil
VITAL SIGN TEMPERATURE : 36.2˚C BLOOD PRESSURE : 130/80mmHg PULSE : 66 bpm RESPIRATION : 20 bpm PAIN SCORE : 2 Weight : 50kg
ACTIVITY DAILY LIVING Loss of appetite X 1/12 and fullness.
Anxious and asking many questions.
Pass motion 2 – 3 times per day
Having intermittent constipation and loose stool X 1/12
PHYSICAL EXAMINATION
S/B Dr DB in clinic :
18KS, CEA & HIV CT Abdomen CXR Tab Dulcolax 11/11 STAT Fleet 45cc at 5am 19/6/13 Colonoscopy CM
UnknownHereditaryAgingDietarySmoking AlcoholRadiation
• Aging• History of colorectal cancer• Inflammatory bowel disease• Family history• Low fiber & high fat diet
RISK FACTORS
• African-American race• Sedentary lifestyle• Diabetes• Obesity• Alcohol• Radiation
RISK FACTORS
• Intestinal obstruction• Gastrointestinal haemorrhage• Cancer cell metastasis to
other organ
COMPLICATION
• Biochemistry - Glucose 6.4mmol/L (3.9 – 6.1 mmol/L)
• Liver Function Test- SGPT / ALT 55U/L (7 – 48)
• Microscopic Examination, Urine- Bacteria Occasional (Nil)
18KS
• 1cm right posterior-based pleural reaction
• No malignancy seen
CT ABDOMEN
• 5mm small nodular opacity right lower zone with well circumscribed border.
CHEST X-RAY
• Both CXR and CT abdomen findings were noted since 2012.
Dr DB wrote :
DRUGSIN WARD
DATEORDERED
DATE OFF
Tab Dulcolax 11/11 STAT 18/6/13 18/6/13
Fleet 45cc at 5am (19/6/13)
18/6/13 19/6/13
DRUGSTO TAKE AWAY
DATEORDERED
Co-Motion 1/1 OM X 5/7 19/6/13
Tab i-1-Zyme 1/1 Daily X 1/12 19/6/13
Alteration in comfort : pain related to abdominal bloating.
NURSING DIAGNOSIS
Potential fall related to sedation.
NURSING DIAGNOSIS
Alteration in emotional status anxiety related to symptoms and treatment.
NURSING DIAGNOSIS
Alteration in nutritional status less than body requirement related to poor appetite, minimal consumption & abdominal fulness / discomfort.
NURSING DIAGNOSIS
Potential infection related to intravenous cannulation.
NURSING DIAGNOSIS
• Follow up• High fiber diet• Stop smoking• Avoid alcohol and junk food • Exercise more• Watch your weight• Relaxation and stress management• Diabetes management
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