NCP Nursing Care Plan for Colorectal Cancer, Colorectal cancer accounts for about 15% of all malignancies and for about 11% of cancer mortality in both men and women living in the United States. It is the third most common cause of death from cancer among men and women, combined. Malignant tumors of the colon or rectum are almost always adenocarcinomas. About half of these are sessile lesions of the rectosigmoid area; the rest are polypoid lesions.
Colorectal cancer tends to progress slowly and remains localized for a long time. Consequently, it’s potentially curable in 75% of patients. With early diagnosis, the 5-year survival rate is 50%. It is potentially curable in 75% of patients if an early diagnosis allows resection before nodal involvement
Causes For Colorectal Cancer
The cause of colorectal cancer is largely unknown; however there is much evidence to suggest that incidence increases with age. Risk factors include a family history of colorectal cancer and a personal history of past colorectal cancer, ulcerative colitis, Crohn’s disease, or adenomatous colon polyps. Other factors that magnify the risk of developing colorectal cancer include obesity, diabetes mellitus, alcohol usage, night shift work, and physical inactivity. It has been strongly suggested that diets high in fat and refined carbohydrates play a role in the development of colorectal cancer.
Complications For Colorectal Cancer
As the tumor grows and encroaches on the abdominal organs, abdominal distention and intestinal obstruction occur. Anemia may develop if rectal bleeding isn’t treated
Nursing Assessment Nursing Care Plan For Colorectal Cancer
Signs and symptoms depend on the tumor’s location. If it develops on the colon’s right side, the patient probably won’t have signs and symptoms in the early stages because the stool is still in liquid form in that part of the colon. He may have a history of black, tarry stools, however, and report anemia, abdominal aching, pressure, and dull cramps. As the disease progresses, he may complain of weakness, diarrhea, obstipation, anorexia, weight loss, and vomiting.
Patient History. Seek information about the patient’s usual dietary intake, family history, and the presence of the other major risk factors for colorectal cancer. A change in bowel pattern (diarrhea or constipation) and the presence of blood in the stool are early symptoms and might cause the patient to seek medical attention. Patients may report that the urge to have a bowel movement does not go away with defecation. Cramping, weakness, and fatigue are also reported. As the tumor progresses, symptoms develop that are related to the location of the tumor within the colon. When the tumor is in the right colon, the patient may complain of vague cramping or aching abdominal pain and report symptoms of anorexia, nausea, vomiting, weight loss, and tarrycolored stools. A partial or complete bowel obstruction is often the first manifestation of a tumor in the transverse colon. Tumors in the left colon can cause a feeling of fullness or cramping, constipation or altered bowel habits, acute abdominal pain, bowel obstruction, and bright red bloody stools. In addition, rectal tumors can cause stools to be decreased in caliber, or “pencil-like.” Depending on the tumor size, rectal fullness and a dull, aching perineal or sacral pain may be reported; however, pain is often a late symptom.
Physical Examination. Inspect, auscultate, and palpate the abdomen. Note the presence of any distension, ascites, visible masses, or enlarged veins (a late sign due to portal hypertension and metastatic liver involvement). Bowel sounds may be high-pitched, decreased, or absent in the presence of a bowel obstruction. An abdominal mass may be palpated when tumors of the ascending, transverse, and descending colon have become large. Note the size, location, shape, and tenderness related to any identified mass. Percuss the abdomen to determine the presence of liver enlargement and pain. A rectal tumor can be easily palpated as the physician performs a digital rectal exam.
Diagnostic tests For Colorectal Cancer
Several tests support a diagnosis of colorectal cancer. Digital rectal examination can detect almost 15% of colorectal cancers. Specifically, it can detect suspicious rectal and perianal lesions. Fecal occult blood test can detect blood in stools, a warning sign of rectal cancer.
- Digital examination.
- Hemoccult test (guaiac).
- Proctoscopy or sigmoidoscopy.
- Colonoscopy permits visual inspection (and photographs) of the colon up to the ileocecal valve and gives access for polypectomies and biopsies of suspected lesions.
- Computed tomography scan.
- Barium X-ray. Barium examination should follow endoscopy or excretory urography because the barium sulfate interferes with these tests.
- Carcinoembryonic antigen, although not specific or sensitive enough for an early diagnosis, is helpful in monitoring patients before and after treatment to detect metastasis or recurrence.
Nursing diagnosis Nursing Care Plan For Colorectal Cancer
- Acute pain
- Deficient fluid volume
- Imbalanced nutrition: Less than body requirements
- Risk for infection
Nursing Key outcomes Nursing Care plan for Colorectal Cancer
- The patient will express that he feels less pain.
- The patient will express feeling less anxious.
- The patient will have soft, formed stools that are easy to pass.
- The patient’s fluid volume will be maintained within normal range.
- The patient will resume a regular elimination pattern.
- The patient will verbalize fears and concerns relating to his diagnosis and condition.
- The patient won’t experience further weight loss.
- The patient won’t exhibit signs or symptoms of infection.
Nursing interventions Nursing Care Plan for Colorectal Cancer
- Pain Management, Analgesic Administration, Environmental Comfort Management, Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient, Use of pharmacologic agents to reduce or eliminate pain, Manipulation of the patient’s surroundings for promotion of optimal comfort
- Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress.
- Constipation/Impaction Management: Prevention and alleviation of constipation/impaction. Bowel Management: Establishment and maintenance of a regular pattern of bowel elimination.
- Fluid Management: Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels. Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded. Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
- Diarrhea Management: Management and alleviation of diarrhea. Fluid Monitoring: Collection and analysis of patient data to regulate fluid balance. Perineal Care: Maintenance of perineal skin integrity and relief of perineal discomfort
- Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
- Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
- Infection Protection: Prevention and early detection of infection in a patient at risk Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making
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