Colon Cancer – Pathophysiology, Podcast, and Nursing Care Plan

Colon cancer

Colon Cancer

 

Colon cancer attacks the large intestine. If the cancer is seen in the last few inches of the colon, it is referred to as rectal cancer.  It is not uncommon to hear the term colorectal cancer when speaking about colon cancer. Usually colon cancer starts as benign (noncancerous) collections of cells referred to as polyps. As time progresses, these polyps may become cancerous. Polyps may be small and cause little to no signs or symptoms. For this reason, regular screening should be recommended to patients to help impede cancer by watching theses polyps before they become cancerous.

Causes of colon cancer:

In many cases, there is no specific cause of colon cancer. Researchers say that malignant cells of colon cancer develops from healthy cells in the colon that have been damaged in some way. When a cell is damaged it can become cancerous. Cancer cells start to multiply and destroy healthy cells. Cancerous cells can travel to other parts of the body, this process is called metastasis.

 

Signs and symptoms of colon cancer:

 

  • A change in bowel habits, including diarrhea, constipation and sudden change in the consistency of your stool
  • Bleeding at the time of passing stools.
  • Abdominal discomfort, such as gas, pain, and cramps.
  • A feeling that your stools are still in your bowel.
  • Weakness or fatigue
  • Sudden weight loss

 

Risk factors for colon cancer:

Some of the risk factors associated with colon cancer include:

    • Diabetes
    • Obesity
    • Smoking
    • Alcohol abuse
    • Older patients
    • African American
    • History of polyps or colorectal cancer
    • Inflammatory intestinal diseases
    • Familial history
    • High fat and low fiber diet
    • Sedentary lifestyle

 

 

 

Diagnositics

Depending on the complaints of the patient, the healthcare provider may order:

    • Colonoscopy to examine the colon
    • CT scans
    • Laboratory tests such as a CBC to check for anemia  and liver function tests

 

 

Staging of Colon Cancer: Staging is done to determine which treatments may be needed to help the patient:

 

  • Stage 0: very early cancer found on the innermost layer of the intestine
  • Stage 1: cancer has grown through the mucosa of the colon, but has not spread any further.
  • Stage 2: Cancer has now grown into the wall of the colon. There is no lymph node involvement.
  • Stage 3: Lymph node involvement is now seen, however, there is no metastasis to other parts of the body.
  • Stage 4: Cancer has metastasis to other organs of the body.

 

 

Staging of Colon Cancer

Treatments for Colon Cancer:

Depending on the extent and type of cancer, the following treatments may be utilized by the healthcare provider:

    •  Chemotherapy: Chemotherapy uses drugs to destroy cancer cells. Chemotherapy is suggested to give after surgery if the cancer cells have spread to the lymph nodes. By doing this treatment, chemotherapy may help reduce the risk of cancer recurrence.

 

  • Radiation therapy: Radiation therapy uses powerful energy. Such as X-rays. Radiation energy helps to kill cancer cells that may remain after surgery. Your doctors may shrink large tumors before an operation so that they can be removed more easily.

 

 

  • Medication targeted therapy: Used with chemotherapy in an attempt to target cancerous cells.

 

 

  • Continuously monitor for complications which can include perforation, infections and peritonitis.

 

 

  • Pain control

 

 

Nursing Care Plan

Nursing Diagnosis

1. Acute Pain related to inflamed bowel as evidenced by patient rates pain at 8/10 on pain scale and states abdominal cramping and tenderness in abdomen.

Desired outcomes:

Patient will report a decrease in pain from 8 to 0 on the pain scale by discharge.

InterventionsRationals
InterventionsRationals
Assess level of pain using appropriate pain scale. Assess pain 30 minutes before and after pain medication is given.Using an appropriate age pain rating scale will help the healthcare providers monitor the level of pain and adjust pain medications as needed.
Administer pain medications as prescribed and indicated.Analgesics are helpful in relieving pain and helping in the recovery process.
Check for number of bowel movements at least once per shift.Immobility caused by pain may decrease the parasympathetic stimulation to the bowel.
Incorporate nonpharmacologic measures to assist with control of pain.Ideally, the use of comfort measures will distract the patient from pain and may increase the effectiveness of pharmacological measures.

2. Imbalanced Nutrition: Less than body requirements related to malabsorption.

Desired outcomes:

Within 24 hours of hospital discharge, the client is able to demonstrate progress towards adequate nutritional status as evidenced by progressive weight gain.

InterventionsRationals
InterventionsRationals
Weigh patient daily. Assess and record (I&O) intake and output.To assess adequacy of diet and measure the use of diuretic therapy if utilized.
Allow client to eat that are permitted within dietary meal plan. Explain dietary meal plan and restrictions.Sodium and fluids are restricted due to fluid retention and ascites.
Offer small and frequent meals.If ascites is present, the patient may not be able to tolerate larger meals.

 

Disclaimer:

Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN-BC, BSN, PHN, CMSRN Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process. She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

One comment

  • CHINFAI

    Dear Dr.Anna,

    I am nursing student in Hong Kong. I would to have the references about “Colon Cancer – Pathophysiology, Podcast, and Nursing Care Plan”. Can you offer me the references?

    Thankyou

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