Care Conference Cancer Colon

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  • 1. 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.
  • 2. 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.
  • 3. PATIENT’S PROFILE  MRS. T  FEMALE  54 YEARS OLD  HOUSEWIFE
  • 4. PATIENT’S PROFILE  WHEEL CHAIR  ANXIOUS  ALLERGICS - NIL  D.O.A 18/6/13 @ 1000 Hrs
  • 5. Mrs T was admitted to 5XX-1 with complaint of intermittent constipation and loose stool with abdominal bloating and discomfort X 1/12.
  • 6. Doctor = Dr DB Diagnosis - CANCER COLON
  • 7. 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
  • 8. CURRENT MEDICATION  Nil
  • 9. VITAL SIGN  TEMPERATURE  BLOOD PRESSURE  PULSE  RESPIRATION  PAIN SCORE  Weight : : : : : 36.2˚C 130/80mmHg 66 bpm 20 bpm 2 : 50kg
  • 10. 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
  • 11. PHYSICAL EXAMINATION
  • 12. 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
  • 13. Unknown Hereditary Aging Dietary Smoking Alcohol Radiation
  • 14. RISK FACTORS • Aging • History of colorectal cancer • Inflammatory bowel disease • Family history • Low fiber & high fat diet
  • 15. RISK FACTORS • African-American race • Sedentary lifestyle • Diabetes • Obesity • Alcohol • Radiation
  • 16. COMPLICATION • Intestinal obstruction • Gastrointestinal haemorrhage • Cancer cell metastasis to other organ
  • 17. 18KS • 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)
  • 18. CT ABDOMEN • 1cm right posterior-based pleural reaction • No malignancy seen
  • 19. CHEST X-RAY • 5mm small nodular opacity right lower zone with well circumscribed border.
  • 20. Dr DB wrote : • Both CXR and CT abdomen findings were noted since 2012.
  • 21. DRUGS IN WARD DATE ORDERED 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
  • 22. DRUGS TO TAKE AWAY DATE ORDERED Co-Motion 1/1 OM X 5/7 19/6/13 Tab i-1-Zyme 1/1 Daily X 1/12 19/6/13
  • 23. NURSING DIAGNOSIS  Alteration in comfort : pain related to abdominal bloating.
  • 24. NURSING DIAGNOSIS  Potential fall related to sedation.
  • 25. NURSING DIAGNOSIS  Alteration in emotional status anxiety related to symptoms and treatment.
  • 26. NURSING DIAGNOSIS  Alteration in nutritional status less than body requirement related to poor appetite, minimal consumption & abdominal fulness / discomfort.
  • 27. NURSING DIAGNOSIS  Potential infection related to intravenous cannulation.
  • 28. • • • • • • • • Follow up High fiber diet Stop smoking Avoid alcohol and junk food Exercise more Watch your weight Relaxation and stress management Diabetes management