Oncology Nursing: Colorectal Cancer Post-Surgery Management Analysis

This report provides an in-depth analysis of oncology nursing, specifically addressing the management of colorectal cancer and post-surgery care. It begins with an introduction to cancer, its various types, and the role of oncology. The main body delves into colorectal cancer, including its causes, symptoms, and available treatments, such as surgery and colostomy. The report then explores different types of colostomies and the associated nursing management, including skin care, colostomy irrigation, and patient care plans. The report emphasizes the importance of critical thinking in assessing patients' physical, social, and emotional needs, illustrated through a case study of a 45-year-old patient with stage 3 colorectal cancer and a temporary colostomy. It covers nursing interventions, justifications, and practical considerations for managing the patient's condition and improving their quality of life. The report concludes with a summary of the key findings and recommendations for effective oncology nursing practices.

Oncology
nursing

Contents
INTRODUVTION...........................................................................................................................................2
MAIN BODY.................................................................................................................................................2
CONCLUSION.............................................................................................................................................11
REFRENCE..................................................................................................................................................12

INTRODUVTION
The main objective of project is to analyses and learns the different management
techniques of cancer for after surgery, so that learner can be able to use these management
techniques in critical situation. Here we are going to learn that how to assess the critical thinking
during the worst situation of cancer after surgery, learn and develop the various oncological
nursing management techniques for madam k, 45 year old lady she is diagnosis with the
colorectal cancer stage 3 recently undergone with the surgery (temporary colostomy).
Cancer is chronic disease which develops due to the uncontrolled growth of body cell
there are the different kinds of Cancer disease based on the part of the body where it generate.
There different oncological techniques and treatment for a particular kind of the Cancer.
Oncology it involves all over the study, treatment and management of different kinds of cancer.
It is a branch of medical science which involves different therapeutic management techniques to
prevent, diagnose or treat the particular cancerous disease. Oncologist treats cancer by the use of
medicines, surgery, and radiotherapy.
Temporary colostomy is the cutting small part of large intestine then the creation of
opening to change the movement of waste from the direction of rectum, as patient is suffering
from colon- rectum cancer. By the temporary colostomy doctors make the other excoriation site
on the body so that the colon- rectum can be treated easily and waste get removed from body
through temporary excretion site called stoma. After the healing of bowel and rectum, in some
cases the large intestine again get joint with the rectum so that waste can get remove from the
original sit of waste removal. Incision site depends on the segment of colon to be use.

MAIN BODY
Explanation on colon cancer and the management
Cancer has become a biggest threat for people nowadays across the globe. It may cause
death of patient in absence of appropriate treatment. There are ample of types of cancer one from
them is Conlon cancer. It begins with intestine and gradually spreads in whole body. There is no
predefined age; it can catch to anyone whether old or young. It happens due to polyps that turn
into colon overtime. To prevent this at early stage medical representatives suggested undertaking
screenings and proper medical diagnostic on regular basis. There are several symptoms this
disease such as extreme weight losing, constantly suffers with digestion issues, feeling weak or
unconsciousness, bleeding from stool. Whenever body starts to demonstrate above stated
symptoms constantly, it is suggested to consult a Doctor and take medical prescribed medical
checkups. Due to progress of medical science, there are numerous treatments are available of
colon cancer like surgery, radio therapy, necessary drugs and many more. It starts when healthy
cells develop changes in their DNA and gradually it damages the other body parts too. There are
certain risk elements also associated with colon cancer. It is analyses that old age people are
more likely to suffer with this but yet doctors are unable to found the reason behind it. African-
American race has great threat to caught colon than people of other races. It may happen because
of inherited genes that pass from one generation to another. People who avoid physical activities,
inactive and already suffering with diabetes are at higher risk of cancer. It is analyzed that
Alcohol, Smoking is the most important reasons of cancer worldwide. So, Government
authorities need to take appropriate steps to make people aware about colon cancer and its
symptoms and how it can impact their body. Although it may cause several major issues
including death but with due awareness among citizens it can be prevent at certain level.
There is several management techniques that can be use in order to manage the health of
people in better manner. Nowadays, medical has achieved exponential growth, numerous
technologies are being used in the field of medical science to cure patients on time. Management
in science comprises uses of IT for health, efficient care and proper treatment of people. The
main aim of to associate management with medical is to ensure better as well as quality services
to consumers to minimize death ration and render a standard lifestyle to healthcare customers. It
is the most recent trend that helps medical representatives such as Doctors, Nurses to provide

effective medical treatment to patients and keep long term relationship with them. In addition, it
ensures to provide appropriate care, diagnostic services, and therapy to people who visit
hospitals in order to improve standard of living of citizens within country. Hence, the objective
to combine medical with management is to design effective medical services that are also cost
effective which can be easily affordable by all. It is crucial aspect to render appropriate medical
services to patients in different nations.
There is some medical surgery which has to done in the case of colon cancer treatment
known as colostomy. It is a process of making of additional opening in the colon, due to the
blockage of colon-rectum because of cancer cell, this is done to make stoma (additional opining)
which help to remove the digestive waste and gives the time to treat the colon-rectum.
Colostomy is can be temporary and permanent depends on the health care process and situation.
And there are the different types of colostomy on the basis of site of opening in the body and on
the basis of type numbers of opening. And there the various nursing and personal management
process for the colostomy.

Types of colostomy on the basis of site
1. Sigmoid colostomy- common type of colostomy done on the bottom part of the
large intestine. Done in the lower left hand side of abdomen in the case of sigmoid
cancer.
2. Transverse colostomy- this is done on the top of the abdomen near to the navel.
3. Descending colostomy- It takes the waste left down side of abdomen and waste
can be pasty and gases.
4. Ascending colostomy- done in the medial right site of abdomen.
Types of colostomy on the basis of numbers of stoma
1. Loop- It is similar to the double barrel colostomy, the large part of colon is bring out of
the abdominal wall and two opining are made but stretch to each other.
2. Single barrel- end colostomy done for the permanent basis, done in the case of rectum
cancer where the rectum is completely removed and the single end of the colon is pull out
of the abdominal wall and then single opening stoma is made.
3. Double barrel- large part of the colon cut and bring outside of abdominal wall then two
openings are made, one for the removal of waste (right side) and one for (left side) leave
for the relaxation of rectum.
Nursing management
For madam k, who is suffering from the 3 stage colorectal cancer, she is feeling
discomfort because of the temporary colostomy and the behavior of society towards her
condition. So for the better improvement of bowel and her medical condition, here is the need to
critical analyses the social, personal, physical problems of madam k and then the selection,
development of different nursing management for madam k through the use critical thinking
skills related to the situation. Madam k needs medical intervention as well as social and
emotional support to feel comfortable, so that she can get well soon.

As madam k is colorectal cancer patient and she recently gone with the temporary
colostomy due to the blockage of rectum, for the treatment and betterment of colorectal. In the
case of colostomy it is important to take care of stoma skin, cleaning skin around the stoma.
Care of skin around the stoma
It is important for every learner of medical to understand that how to manage the cleaning
and other factors of stoma skin. The skin color of stoma should mach the color of abdomen;
because of the colostomy outputs skin of stoma some time get tender or sore. But there is some
management process which helps to keep stoma skin healthy.
 Application of aureate size pouch and skin barrier opening- the imperfect size of
pouch unequal to the stoma can cause injury to the stoma and swelling. So it is
important to use the perfect size skin barrier.
 Replacement of pouching system in regular basis- To prevent the leakage and skin
irritation. That is necessary to maintain the changing schedule of pouch, to avoid
leakage and itching.
 Careful removal of pouching system- this step should be done with genital hand
by pushing the body away from the sticky pouch to prevent any herm of the
stoma.
 Cleaning of the skin around the stoma- during the change of skin barrier it is
important to clean the stoma skin with water, and then dry the skin with the help
of towel.
 Prevent sensitivity and allergies- if patient is getting irritated by the particular
brand of pouch than change the pouch to avoid the chances of allergies.

Colostomy irrigation: It is the scheduled removal of waste and cleaning of stoma, that
means empty the colon at given time, it helps to avoid constipation. Helps to stop the discomfort
of patient by preventing the constipation, etching, irritation. It objective is to clean the colon and
rectum, to help in the regular movement of bowel, relieve flatulence. This is the part of nursing
intervention which has to done after the surgery to regulate the migration of bowel and to avoid
the constipation. Irrigation cone is much batter then catheters, it is safe and helps in better water
flow.
Material required for the colostomy irrigation is
1. Enema can and tubing
2. Three emesis basins
3. Bath blanket
4. Warm water in basin
5. Bath towel
6. Bedpans for collecting the return flow
7. Irrigation solution
8. Newspaper
9. Soap, rubber sheet, small colon tube, plastic apron, colostomy dressing tray, wash cloth.
Care plane
Nursing interventions justification
Brief explanation given to the patient To get cooperate management of care plane

with help of patient too.
Clean hands To prevent the contamination
All the equipment should be in the side of bad
and provide privacy.
For saving the time and helps to maintain
the dignity of the patient.
Sagest the patient to turn on his left side or at
comfortable side.
For helping the nurse to do the procedure
without any problem.
Keep the emesis basin and newspaper at the
foot of the bed.
To confirm that the waste are properly
disposed.
Expose the abdomen; drape the patient with the
bath blanker if necessary.
Draping is a part of patient privacy.
Removal of the solid waste and dressings. To avoid the contamination and control
odor.
Place the basin for return flow immediately
under the stoma.
To avoid the leakage.
Open the clamp on the tubing and allow a
small amount of solution to flow into the basin.
To avoid the crimpy pain by preventing the
air bubbles to introduce into the colon.
Lubrication of the colon tube tip. To help in the smooth insertion of the tube.
Insertion of colon tube in miserable amount 6-
8 inches into the stoma.
To avoid irrigation of the intestinal mucosa.
Keep the enema approximately 12 inches
above the bed to allow the solution to flow
slowly.
To prevent the cramping pain of rapid flow.
Clean and empty the first basin immediately. So that it will get ready for the further use if

needed.
After the irrigation, clean the area with soap
and water, then apply the clean dressing to the
area.
It provides comfort to the patient by
preventing allergies.
Keep bake the equipment to the utility room, at
proper place after cleaning them.
Helps in maintaining long life of
equipments.
After the nursing medical intervention there is other most important thing which has to be
managed by patient family and nurse, to help madam k to get cop up from the discomfort area,
she needs a physical as well as emotional support from the side of family friends. As a nurse or
medical student you should understand her situation and do not react so weird for her health
issues it’s your responsibility to help her feel comfortable and normal. There should be proper
diet plain for patient, day routine, and some funny activities to make her feel batter. She needs a
centered care plain where her all requirement should be fulfill. There other important thing to
improve is the mentality of society and the people around the patient guide them that how to treat
the patient at that condition of life, family and friends support help patient to get mentally and
emotionally fit and medical intervention helps in the prevention of colostomy discomfort. So that
the treatment of colorectal cancer accomplish in easy way and then she get the normal way of
living by changing the temporary colostomy into the original excretion process.
General guidelines for diet
Patient need to have diet which helps in the healing of colon and prevent the discomfort.
 Diet plain should break into the 6 small parts rather than 3 large, small amount of food
within the 6 breaks throughout the day.
 Patient should eat slowly and chew the food properly.
 Drink 8-10 glass of water throughout the day which helps in nourishment and prevent the
dehydration.
 Diet plain should involve low fiber food items.

So all over the care is done by the family and personal nurse at home and nurse should be
aware of types of pouch and she should guide the family for the emergency case about all the
medications and cleaning techniques. So that family can help in the absence of nurse. Rather
than medical and clinical support nurse should help the patients emotionally and socially by
exposing her to the nature and providing some social activity. Nurse is somehow responsible for
the motivation of patient after the family, because due to the long time togetherness they get
closes to each other.
CONCLUSION
After study the above content it has been concluded, that the cancer is well known
cornice disease but the medical treatment and diagnosis can become additional problem for the
patient to manage that situation. It is very difficult to manage the various requirement of that
particular treatment. By concerning the case of madam k it has been identified that the medical
diagnosis of colorectal cancer is very sophisticated and delegated process, where it needs the
highest care and support. Colostomy is alternative for the natural process of excretion but it very
difficult than normal procedure of human body and its management is more complicated. But the
complication get solve by the critical thinking and innovative solutions of medical science, with
the proper diet, medical intervention and innovative equipment it become little bit easy to
manage the problem and prevent the pain of patient. Centered care plain help more in the patient
recovery as it done on the basis of patient priority and demands. Where the patient gets cantered
and all needs of patient get fulfill by the family, friends and nurses.