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