The body temperature was higher with systolic hypertension

Running head: NURSING
Nursing-Medical Surgical
Name of the Student
Name of the University
Author Note

1NURSING
Table of Contents
Question 1........................................................................................................................................2
Question 2........................................................................................................................................3
Question 3........................................................................................................................................5
Question 4........................................................................................................................................7
References........................................................................................................................................9

2NURSING
Question 1
The patient Ted Williams, an octogenarian is currently in post-operative care, after being
subjected to a bowel resection surgery and temporary colostomy. In the words of the Roper,
Logan and Tierney model of nursing appropriate clinical judgment, disease diagnosis,
development of care plan, implementation of intervention, and evaluation of health outcomes
form core aspects of nursing (Holland & Jenkins, 2019). The bowel resection surgery will
significantly affect activities of living of Ted, principally on movement, excretion, breathing,
sleeping, and self-care. On assessing the patient, inspiratory crackles and moist productive cough
were observed and the assessment confirmed slightly higher respiration rate (26 bpm). The body
temperature was higher (38.1°C), with systolic hypertension (135/85) and normal oxygen
saturation levels (94%). Additionally, Ted reported a pain score of 4-5/10 that increased on
palpation.
The surgery is expectedly to result in substantial biopsychosocial impact by subjecting
the patient to psychological anguish and agony, in addition to causing apprehensions and worry
amongst his family members, who do not live with him. Not only will the surgery cause major
monetary distress, but isolation from family would also prevent easy recovery from the condition
(Hallowell et al., 2017). Surgical patients have often been found to seek solace in spiritual
activities and teachings. Thus, Ted might show an interest in obtaining assistance from a spiritual
leader for coping with the surgery. It is anticipated to improve his recovery from the current state
(Tajbakhsh, Hosseini & Rahgozar, 2016). Despite lack of information on his cultural viewpoint,
if the health professionals are not culturally competent, Ted will demonstrate a poor health
outcome (Fayi et al., 2018).

3NURSING
Question 2
Analysis of the case scenario suggests that the patient Ted had been suffering from malignant
colorectal cancer. Colorectal cancer typically originates from the lining of the epithelial cells
near the rectum or colon, of the gastrointestinal tract. The condition frequently occurs due to
mutations in the Wnt signalling pathway that results in upregulated signalling activity (Schatoff,
Leach & Dow, 2017). Pathophysiology of his condition can be accredited to mutation in APC
gene that is responsible for the production of APC protein. This protein inhibits β-catenin
accumulation. Therefore, in absence of this protein, there was a build-up of β-catenin that got
translocated to the nucleus, following which it formed a bond with the DNA, and resulted in the
activation of proto-oncogene transcription (Han et al., 2017).
In addition colorectal cancer, as reported by the patient can also be attributed to the activation of
mother proteins like DCC (Deleted in Colorectal Cancer) and TGF-β. Additionally, there is a
growing body of evidence for the overexpression of particular oncogenes in colorectal cancer
such as, those responsible for encoding the protein PI3K, RAF, and KRAS, all of which under
normal circumstances, stimulate division of a particular cell, in relation to growth factors (Filbin-
Wong, Gonen & Kieft, 2018). The aforementioned proteins acquired mutations that are
responsible for cell proliferation. The patient Ted reported signs and symptoms of several risk
factors that increased his likelihood of suffering from colorectal cancer, due to which he was
subjected to a temporary colostomy.
From the case scenario it was found that he had a history of type 2 diabetes mellitus, gout
and obesity, in addition to having suffered from heart failure. Research evidences elaborate that
T2D is correlated with the higher risk of suffering from colorectal cancer, in both males and
females, particularly during the initial months after diagnosis of diabetes, and the risk is greater