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