This document provides information on a 54-year-old female patient, Mrs. T, who was admitted to the hospital with complaints of intermittent constipation, loose stool, abdominal bloating and discomfort for the past 1 month. She has a history of right hemicolectomy in 2007 and colonoscopies in 2011 and 2012. Her diagnosis is cancer of the colon. The nursing diagnoses identified include alterations in comfort due to abdominal pain, emotional status due to anxiety over symptoms and treatment, nutritional status due to poor appetite and potential fall and infection risks.

2. 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.

3. 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.

5. PATIENT’S PROFILE
 MRS. T
 FEMALE
 54 YEARS OLD
 HOUSEWIFE

6. PATIENT’S PROFILE
 WHEEL CHAIR
 ANXIOUS
 ALLERGICS - NIL
 D.O.A 18/6/13 @ 1000 Hrs

7. Mrs T was admitted to 5XX-1
with complaint of
intermittent constipation
and loose stool with
abdominal bloating and
discomfort X 1/12.

8. Doctor = Dr DB
Diagnosis
- CANCER COLON

9. 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

10. CURRENT MEDICATION
 Nil

12. VITAL SIGN
 TEMPERATURE
 BLOOD PRESSURE
 PULSE
 RESPIRATION
 PAIN SCORE
 Weight
:
:
:
:
:
36.2˚C
130/80mmHg
66 bpm
20 bpm
2
: 50kg

13. 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

14. PHYSICAL EXAMINATION

15. 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

29. Unknown
Hereditary
Aging
Dietary
Smoking
Alcohol
Radiation

35. RISK FACTORS
• Aging
• History of colorectal cancer
• Inflammatory bowel disease
• Family history
• Low fiber & high fat diet

36. RISK FACTORS
• African-American race
• Sedentary lifestyle
• Diabetes
• Obesity
• Alcohol
• Radiation

38. COMPLICATION
• Intestinal obstruction
• Gastrointestinal haemorrhage
• Cancer cell metastasis to
other organ

42. 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)

43. CT ABDOMEN
• 1cm right posterior-based
pleural reaction
• No malignancy seen

44. CHEST X-RAY
• 5mm small nodular opacity right
lower zone with well
circumscribed border.

45. Dr DB wrote :
• Both CXR and CT abdomen
findings were noted since 2012.

48. 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

49. 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

55. NURSING DIAGNOSIS
 Alteration in comfort :
pain related to abdominal
bloating.

60. NURSING DIAGNOSIS
 Potential fall related to
sedation.

66. NURSING DIAGNOSIS
 Alteration in emotional
status anxiety related to
symptoms and treatment.

69. NURSING DIAGNOSIS
 Alteration in nutritional
status less than body
requirement related to
poor appetite, minimal
consumption & abdominal
fulness / discomfort.

72. NURSING DIAGNOSIS
 Potential infection
related to intravenous
cannulation.

78. •
•
•
•
•
•
•
•
Follow up
High fiber diet
Stop smoking
Avoid alcohol and junk food
Exercise more
Watch your weight
Relaxation and stress management
Diabetes management