Question

In: Nursing

Bruce is a 47-year-old man who decides he needs to visit his doctor due to some...

Bruce is a 47-year-old man who decides he needs to visit his doctor due to some gastrointestinal symptoms. At first it just started out as a bit of abdominal pain and cramping, followed by diarrhea so at first Bruce just thought he had a stomach bug. But weeks went by and the diarrhea just increased in frequency and instead of feeling better he started to feel really fatigued. This has been going on for 8 months before his wife finally convinced him to make an appointment with a doctor, who then referred him to a gastroenterologist. A couple of months later when he finally goes to his specialist appointment, Bruce admits after questioning that he has had bleeding with his stool but he didn’t want to tell the doctor as he was embarrassed and didn’t want to get checked for hemorrhoids. The gastroenterologist also asks many questions about Bruce’s diet and his weight and discovers that Bruce has lost 15kg in the past year despite eating a lot of hot chips and mashed potatoes – the only thing Bruce feels doesn’t make his diarrhea worse. The gastroenterologist then tells Bruce he would like to perform a colonoscopy to investigate further.

After the colonoscopy the surgeon tells Bruce that they found a number of polyps in his bowel which is not necessarily a cause for concern as many polyps are benign, but they will have to wait on the results of the biopsies to make sure none of them were malignant. A week later the surgeon calls Bruce, unfortunately it is bad news – the biopsy shows evidence that the growth is malignant and anaplastic and that they can’t rule out metastatic growths. Bruce is called back in for follow up tests and they find that there is an abnormal growth in his liver also.

Bruce is now sent to an oncologist, who recommends that he has surgery to remove any remaining polyps, a small portion of his bowel, and the abnormal growth from his liver. Based on the advice from his oncologist, Bruce also decides to undergo chemotherapy treatment. Whilst doing some routine checks after his treatment, Bruce is informed he has neutropenia.

Question 9

Bruce doesn’t understand what the surgeon and oncologist are saying after the results because he doesn’t understand the terminology being used. Explain in terms a patient could understand what is meant by malignant, anaplastic and metastatic and what does this then mean for his prognosis. In order to help explain these terms compare Bruce’s growth with a benign, differentiated and localised growth.

Question 10


Describe two cancer cell characteristics or properties that allow them to become invasive and

metastatic.

Question 11
Explain why Bruce experiences the clinical manifestations of increased risk of infection and fatigue,

both before and after treatment for his cancer.

Question 12

Discuss two measures that may minimize Bruce’s chances of contracting coronavirus. In your answer, identify two different links in the chain of infection that can be broken and explain how they are broken.

Solutions

Expert Solution

9.The terminology malignant in simple refers to growth of abnormal cells in a faster way and it is often cancerous

Anaplastic in simple refers to abnormality present in the nature of the cells especially in its contents or characteristics

Metastatic refers to the invasion of the abnormal type of cancer cell to other site from the point of origin

Usually the cells grows abnormally first called as bening. If this is left untreated it can lead to differentiation of the cells . Overtime it can turn completely to abnormal cells in the particular site.

10.The characteristic like very faster abnormal cells can invade to the nearby cells in the tissue and make it an invasive cancer .At the same time when the cells are mobile it can invade the nearby site ,tissue or organ causing metastasis .

11.The increased risk of infection is due to the low level of white blood cells (WBC) . This decreases the immunity to fight any infection.

At the same time loss of body weight due to prolonged diarrhoea could have altered the metabolic functioning and bleeding whole passing stool could have decreased the level of hemoglobin in the body .When the level of hemoglobin is low the person develops anemia as a result fatigue occurs.

12.The two measures which may minimise the chance of corona virus are

  • Use of personal protective equipment like face mask as corona virus can spread through air ,droplet ways (This can break the chain of infection from source to host)
  • Maintain hand hygiene (this can prevent the spread from agent ,break the portal of exit )
  • Maintain social or physical distance (this breaks the mode of transmission )

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