Lewis: Medical-Surgical Nursing in Canada

Case Studies Questions

Chapter 41: NURSING MANAGEMENT: Lower Gastrointestinal ro!le"s

Colorectal Cancer Client Profile #oseph S"ith$ a %&'(ear'old )hite "an$ li*in+ in southern ,ntario- .is /a"il( has !rou+ht hi" to hospital /or e*aluation$ due to a re0ent deterioration in his healthSubjective Data 1 Co"plains o/ !ri+ht red !leedin+ durin+ a !owel "o*e"ent 1 2a"il( states that he has !e0o"e thinner o*er the past se*eral "onths$ and has little appetite 1 3es0ri!es /eelin+ wea4 and !ein+ easil( /ati+ued5 he appears ill 1 Co"plains o/ a!do"inal pain and a /eelin+ o/ /ullness 1 .e has noti0ed a 0han+e in the si6e o/ his stools 7"ore thin$ pen0il'li4e8 1 No prior s0reenin+ /or 0olore0tal 0an0er5 /a"il( histor( o/ 0olore0tal 0an0er is un4nown Objective Data Physical Examination 1 Te"perature o/ 9&:C 71;;-4:28 1 .eart rate o/ 1;; !eats<"in5 = is 1>;<?4 "" .+ 1 )ei+ht: @9-@ 4+ 714; l!s85 hei+ht: 1?>-% 0" 7% /eet$ A in0hes8 1 Mild palpation o/ des0endin+ 0olon eli0its dis0o"/ort 1 3i+ital re0tal eBa" re*ealed a "ass Diagnostic Tests 1 Colonos0op( re*eals distal re0tal 0an0er 1 .0t: ;->@ 7>@C8 1 .!: A; +<L 7A +<dL8 Critical Thin ing !uestions 1- )hat are the si+ns and s("pto"s o/ 0olore0tal 0an0er that Mr- S"ith "ani/estsD >- )hat is the si+ni/i0an0e o/ Mr- S"ithEs ta0h(0ardiaD 9- )hat t(pes o/ dia+nosti0 in/or"ation are a*aila!le /ro" a 0olonos0op( *ersus a dou!le' 0ontrast !ariu" ene"aD 4- )hat nursin+ inter*entions are indi0ated /or Mr- S"ith at this sta+e o/ his illnessD %- )hat does the nurse need to do to support Mr- S"ith and his /a"il( in "a4in+ de0isions a!out his 0ontinued health 0areD
Cop(ri+ht F >;;? !( Else*ier Canada$ a di*ision o/ .ar0ourt Canada$ Ltd-

Case Studies Questions @- =ased on the assess"ent data$ write one or "ore nursin+ dia+noses- Are there an( 0olla!orati*e pro!le"sD

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Cop(ri+ht F >;;? !( Else*ier Canada$ a di*ision o/ .ar0ourt Canada$ Ltd-