Case study – Colorectal cancerPatient profileGiovani Carboni, a 56 year old man, has a market garden in a rural township. Mr. Giovani's wife and family drove 30km to take him to the nearest hospital because of his deteriorating health. Subjective data: . Complains of bright red bleeding during a bowel movement. Family states that has become thinner over the past several months and has little appetite. . Describe feeling weak and being easily fatigued; he appears ill. Complains of abdominal pain and a feeling of fullness. Bowel pattern has episodes of constipation followed by diarrhea.
No prior screening for colorectal cancer; family history of colorectal cancer is unknown. Objective data: Physical examination. Temperature: 38 degrees. Heart rate: 100 bpm; BP: 120/74mmHg. Weight: 63.6kg; height: 172.5cm. Mild palpation over transverse and descending colon elicits pain. Digital rectal examination revealed a mass. Laboratory test. Double-contrast barium enema showed two medium-sized tumors. Haematocrit: 26%. Hemoglobin level: 90g/L. (Brown & Edward, 2005)Analysis of the condition: From the condition the patient is presented in with and from the lab and diagnostic study it could be seen that the patient is suffering from colorectal cancer.
This could\d be assumed from the bleeding during bowel movement, feeling week and fatigued, thinning all due to blood loss, severity shown by low hemoglobin level, 90g? L ( normal for 50 years men is 140- 1774 g/L) and lower haematocrit value- 26% (normal- 40-54%), suggesting a impending addition of anemia. The feeling of fullness and alternating pattern of diarrhea and constipation, adds to the finding. The rectal scan confirms the presence of medium sized tumor. This warrants the start of immediate medication and further care. Additionally the complete family history has to be again obtained to look in for any hereditary condition that could ease up the process of proper diagnosis.
Before getting into nursing care, it becomes impervious to understand the situation. Description of condition: Colorectal cancer described to be the third most common cancer occurring both in men and women. Statistics shows that by the year 2007, over 150,000 cases of colon and rectal cancer will be diagnosed, and more than 52,000 people will die from the disease, accounting for about 10% of all cancer-related deaths. ( Brotzman and Russell Robertson, 2007) Colorectal cancer, also called colon cancer or large bowel cancer could be described as cancerous growths in the colon, rectum and appendix.
Many colorectal cancers are thought to arise from adenomatous polyps- mushroom like growth, in the colon. As any other type, they are also usually benign, but at times develop into cancer. The main concern here is that often the colorectal cancer goes unnoticed in its early stage, almost symptom less till the advanced stage. (Chao etal. ,2005). The main symptoms for the colorectal cancer are, change in bowel habits, change in frequency (constipation and/or diarrhea), change in the quality of stools, change in consistency of stools, Bloody stools or rectal bleeding, Stools with mucus, Tarry stools Feeling of incomplete defecation or reduction in diameter of feces or rarely bowel obstruction.
On other hand it can be constitutional symptoms. But generally Anemia, with symptoms such as dizziness, malaise and palpitations. Can be seen, clinically with manifestations as change in pallor, low hemoglobin level etc. also at times can be seen Anorexia, Asthenia, and weakness and Unexplained weight loss.
These are the common symptoms seen. But when it reaches metastatic stage, symptoms as shortness of breath as in lung metastasis, Epigastric or right upper quadrant pain, as in liver metastasis can be seen. ( Park etal. ,2005)