CASE STUDY.CANCER OF THE COLON WITH METASTASIS.

A 45years male stage 1V colon cancer that has metastasized.Oncology consult done and completed.Alert and oriented ×4.NPO x medications for surgical procedures. Right colostomy placed ,jacksonpratt( JP) in place.Dressing intact and in place.0.9NS at 100ml/hour infusing via pump to left forearm saline lock 20guage IV ,clean dry and intact. Weight 110lbs,Height 5ft 6inches.No skin impairment except the surgical site.

Laboratory tests done .

H/H 6.9,24.1.Replaced with two units of PRBC.K level 3.0 replaced with 60mEqkcl IV infusing slowly.

Medications.

Immune Globulin(40gm)in 400ml sterile water IV Q24hours.Albuterol sulfate 2puff Q4hours prn INH.Furosemide 40mg daily po scheduled. Guafenesin syrup 10ml Q4hours prn cough. Hydrocodone/Acetaminophen 10/325mg Q6hours prn moderate pain.Morphine 2mg IV Q3hours prn severe pain. Dilaudid 0.5mg IV Q3hours prn severe pain. Pantoprazole 40mg po QAMAC IVP.Spironolactone 25mg QDaily scheduled. Diet : Clear liquid diet.Voiding well using the bed pan with assistance.

Colon is the portion of the large intestine that is extending from Cecum to the rectum.In assessment of bowel elimination includes the physical assessment of the abdomen, anus and rectum.The sequence of abdominal assessment goes from inspection of the abdomen, then auscultation then percussion to palpation.Auscultation must be done before palpation because palpation of the abdomen will disturb normal peristalsis.Position patient in supine position and expose the stomach. The chest and the public area covered and the bladder emptied.The warning signs of colon cancer are as follows. A.Blood in the stool.B.Change in the characteristics of the stools 🛑 C.Abdominal or rectal pain.D.The feeling of sensation after emptying of the bowel.

QUESTIONS AND ANSWERS.

1. The doctor orders the patient to avoid foods that laxatives effect.What food should the nurse ask the patient to avoid?.

A.Rice.

B.Alcohol.

C.Eggs.

D.Cheese.

Correct answer B.It is an alcohol that has constipation effect.

2.The patient complaints about excessive flatulence. Which food of constantly will lead to this?.

A.Cauliflower.

B.Chicken.

C.Ice cream.

D.Pasta.

Correct answer A.

Rationale.Cauliflower is gas producing food that results in flatulence.

4. Barium enema should be done before the upper gastrointestinal series due what?.

A. Barium should not be recommended. B.The doctor ordered it.

C.Barium causes gastrointestinal bleeding. D. Because the retained Barium may cloud the colon.

5.What position will you place your patient that is experiencing flatulence?.

A.Knee-chest position.

B.Flower position.

C.Semi-flower’s postion.

D.Trendelenburg position.

Correc answer is A.

Rationale: Knee- chest position facilitate the passing of flatus.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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