colon cancer and ostomies Flashcards
(24 cards)
rf colon cancer is highest in clients with hx of
inflammatory bowel disease
faily hx of colon cancer
75% survival rate if
caught and treated early
hereditary colon cancer
6%
diet that people at rf colon cancer
high fat, high protien, decreased fiber
colon cancer may start as
a benign polyp, become malignant, invade and destroy normal tissues, mets to the liver, peritoneum and lungs
common symptoms of colon cancer
change in bowel habits passage of blood in stool anorexia wt loss fatigue
right sided lesions
dull abd pain and melena (black tarry stools)
left sided lesions
symptoms associated with obstructions (cramping, narrowing stools, constipation, distension, bright red tarry stools
retal lesions
tenemus, rectal apin. reeling of incomplete evacuation, alternating diarrhea, constipation, bloody stools
pt unsymptomatic untill late stages
diagnostics of colorectal cancer
physical exam
fecal occult blood
barium enema- do last so you can do other tests
proctosigmoidoscopy
colonoscopy
identified by colonoscopy smears and biopsy
CEA studies
monitors prognosis after resection, should be normal after 48 hrs, not as reliable as PSA
complications rt tumor growth
obstruction perferation abcess peritonitis sepsis shock extension of tumor
treatment of colon cancer
chemo and surgical resection- alot more effective
chemo- 5-fu and leucovorin (a lot more effective)
types of surgical excisions
segmentail resection w anatamostis
abdominal peritoneal resection with permanent sigmoid colostomy
temporary or permanent sigmoid colostomies
PCs of colorectal cancer
intraperitoneal infection large bowel obstruction GI bleed bowel perferation peritonitis, abscess, sepsis
surgical preparation for colorectal cancer
build clients stamina prior to procedure (exercise/good diet)
increase calories, protien, CHO, decrease residual diet, full liquid diet 24-48hrs before to decrease bulk
TPN may be needed to replace nutrients vits and minerals
cleanse bowels with laxatives, enemas, colonic irrigations night before and day of
NG to suction
complications with stoma
leakage
prolapse
retraction
perferation
colorectal cancer complications
fecal impaction
skin irritation
wound care- could be a hemorrhage at site
how long until stoma functions?
3-6 days
transverse colostomy
soft and smushy colostomy
irritates the skin
descending or sigmoid colostomy
stool fairly solid and slightly irritating to the skin
stoma should be what color?!
pink! if its blood call DR
sigmoid colostomies may need what to promote evacuation
irrigation
avoid what kinds of foods with a colostomy?
cabbage, fish, eggs, beans, peanuts, prune juice (foods that create alot of gas)
