Question

A.P is a 67-year-old man who is admitted for a colon resection following a diagnosis of colorectal cancer. At time of admission, he complains of constipation, bloody stools, abdominal pain, and weight loss. He is 6 feet 1 inch tall and weighs 200 lb. He smokes 1 pack of cigarettes/day. A.P. has a history of coronary artery disease and hypertension. He reports taking antihypertensive medication and 81 mg of aspirin daily. He is admitted for abdominal surgery for his stage 1 tumor. Postoperatively, he will have a temporary colostomy.

What risk factors did the patient have? What is the priority care before surgery? What interventions are appropriate to help alleviate his stress preoperatively? What are some nursing management strategies for this patient postoperatively?

Answer 1

COLORECTAL CANCER :

Colorectal cancer is defined as the cancer that affecting the caecum ,colon and rectum .

STAGE 1 COLO RECTAL cancer: it invades submucosa,treatment is surgery to remove the tumour and some surrounding lymphnodes .

1) answer:

• Age is the non modifiable risk factor (67yrs).
• smoking
• hypertention
• coronary artery disease ,,which he is having i mentioned here.

2) answer:   

• Patient is suffering with coronary artery disease ,so we have to advice patient to go for cardiology consultation to reduce the Risk.
• Patient is using tab .aspirin ,,so we have to advice the patient to stop the tab.aspirin before 1week going to surgery .because aspirin will have potential to increase the bleeding post operatively .
• for HTN ,advice to take medication to decrease bp .
• others are : CBC COUNT ,colonoscopy,chest radiography, prophylactive antibiotics ,deep vein thrombosis prophylaxis ,enema if needed.

3) answer:

• Nurse should explain about the patient disease status ,prognosis .
• nurse should explain about the surgery ,what may happen in operation theatre and what are the advantages of operation in colo rectal cancer to alliviate the his stress.
• nurse should clarify the doughts of the patient very clearly to decrease his stress Preoperatively .

4) answer:

• Immediately after the surgical intervention ,primary duty of nurse is to assess the conscious level of the patient .
• nurse should check the vital signs of the patient .
• nurse should administer the iv fluids to the patient to decrease the dehydration of patient and it will help to prevent hypovolemia of patient after surgery.
• Nurse should provide proper positioning to client.
• Nurse should administer the oxygenation to client .
• nurse should educate the patient to take high fibre dient to relieve constipation.
• advice to decrease the animal fats red meat
• advice for cessation of smoking.
• Advice for excercises.
• secondary prevention with screening and followup .