Nursing Management of Stage 3 Colorectal Cancer: A Case Study

This report focuses on the nursing management of Stage 3 colorectal cancer, emphasizing evidence-based practices and patient-centered care. It begins with an introduction to oncology and colorectal cancer, including diagnostic methods and treatment options like surgery, radiation, and chemotherapy. The report then delves into specific nursing interventions, such as managing pain, addressing fatigue, and supporting patients with daily living activities, including tingling in limbs. The discussion incorporates relevant evidence from various studies to support the nursing strategies. Furthermore, it covers the initial phase of patient care, the importance of holistic needs assessment, and the use of patient experience surveys to build confidence. The report also highlights the significance of patient education, including explaining the disease, treatment side effects, and the importance of lifestyle modifications, wound care, and follow-up care after surgery. Overall, the report aims to provide a comprehensive understanding of the critical role nurses play in the care of patients with Stage 3 colorectal cancer, aiming to improve their quality of life and outcomes.

ONCOLOGY- NURSING
MANAGEMENT FOR 3RD STAGE
COLORECTAL CANCER

Table of Contents
INTRODUCTION...........................................................................................................................1
COLON CANCER AND THEIR MANAGEMENT WITH SPECIFIC EVIDENCES.................1
DEMONSTRATES THOROUGH AND CRITICALLY DISCUSSION ON NURSING
MANAGEMENT FOR MADAM K CREATIVELY INCLUDES RELEVANT AND
SPECIFIC EVIDENCE...................................................................................................................4
Initial phase............................................................................................................................4
Fatigue ...................................................................................................................................5
Pain........................................................................................................................................5
Limiting daily living activity..................................................................................................6
Tingling in limbs....................................................................................................................6
Telephonic enquires................................................................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
The oncology is termed as the treatment and management of cancer. The oncology
describes how fast and intensely with a proper caring and skill of management will lead to make
a patient comfort. The person who deal with the diagnosis process and treatment is called
oncologist. The oncologist follow the comfortable path to the patient. The oncologist usually
preferred the right path on cancer. They grow through all aspect and circumstance that create
comfort to patient after a time while. The third stage of cancer of colorectal was critical in the
time of surgery, colorectal cancer can also be know by different term such as rectal cancer,
colon tumour (if cancer grows in the rectum and colon) symptoms blood clotting,weight loss,
fatigue. Some other manes are intestine cancer, etc. The diagnostic method are tissue biopsy.
The treatment are generally go through surgery, radiation therapy, chemotherapy etc. (San
Hipólito-Luengo and et. al., 2017).
COLON CANCER AND THEIR MANAGEMENT WITH SPECIFIC
EVIDENCES
The colon cancer are probably due to the old age and lifestyle factor, the visual is clear
there are few cases which is due to genetic disorder. The risk factor improper diet, cigarette ,
deficiency in Daly workout , obesity, and lack of knowledge about physical diet routine. The
dietary factor which can cause harm are different kinds of meat and unusual alcoholic drink
consumption for a long term. The another risk factor are crohn's disease and ulcerative colitis.
And the genetic colon cancer are very less in number, with a data record it is less than 5% of
cases. The colon cancer started with the benign tumor and after a time form a polyp. With time
becomes cancerous cells (Araghi and et. al., 2019).
Colon cancer diagnosed by taking the sample of the colon during a sigmoidoscopy or
colonoscopy. Treatment are used for colon cancer may include some drugs at initial stage. After
a time the option are disclosed are surgery, radiation therapy, chemotherapy, and targeted
therapy. If the patient get tested for the colon cancer in the starting stage than it can be cure but if
it analysed at last stage than only symptoms and pain can be relived by palliation, becouse at last
stage it is not possible to cure the cancer only we help the patient to be comfortable and pain
free.
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When the colon cancer are at their different stage the treatment are different they are :
Stage 1: resection and polypectomy for the smallest and the for larger tumors.
Stage 2: resection and anastomosis, sometime followed by clinical trails of chemotherapy,
radiation.
Stage 3: resection and anastomosis followed by either chemotherapy or clinical trails of
chemotherapy.
Stage 4: resection and anastomosis, removal of parts of other organs to which the cancer has
spread, radiation and standard chemotherapy, clinical trails of chemotherapy (Siegel and et. al.,
2017).
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Illustration 1: colon cancer

The pain management after the surgery is processed for patient in the terms of drugs are:
For patient not receiving epidural analgesia- COX-2 selective inhibitors however, they may
contribute to an early anastomotic leakage. Continuity of lido-cane infusion through iv route.
And the systemic based options are- COX-2 selective inhibitors which only for patient not
receiving epidural anaesthesia. And also COX-2 selective NSAIDS, non selective NSAIDS and
calcium channel antagonist (gabapentin and pregabalin) should be considered as a parts of a
postoperative multimodal pain management regimen. Paracetamol is on;y recommended for
moderate or low pain in combination with COX-2 inhibitors or conventional NSAIDS. Patient
pain control related to the colorectal cancer after the surgery shows variations, in comparison to
the previous medical report. For controlling the postoperative pain it needs to do transmission of
multimodal analgesia. In most cases importance of patient report results are ignored and exude in
comparison to the surgical conclusion registries and it is important to improve on the basis
patient. (Manerba and at. al., 2017).
This describes that after discharging form the hospital by surgery there is 100% chance of
discomfort which can be face by patient after the operation, important thing is to collect contacts of
health-care team so that family will we able to inform the health officers in emergency.
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Illustratio
n 2: colon resection

Because of the log time treatment and stay in the medical institution, to get overcome from the health
problem after discharging from the hospital, patient need time to maintain and recover mental and
physical health of . plan your day according to the rest sleep/sleep in the afternoon.
Pain and pain relief- after surgery many of people experience some pain, this will be
managed with pain killers and improve over time. A small supply of pain killers will be arranged for
to take home in emergency pain (Saitoh and et. al., 2016).
Wound healing- the wound fully healed up before home. If still their needs a wound dressing
then a put nursing staff for care and medical support. All wound progress through several stages
healing and may able ton see changes in wounds. The following points are commonly experience are
unusual sensation, such as numbness, tingling or itching, slight pulling around the qlue, stitches or
staple as the wound and a hard lumpy feeling as new tissue forms. Sometime the infection may
developed in the wound. Which may increased the redness of the skin or to oozing of a pus like fluid
form the wound. And at this cases the wound healing may get delayed.
Diet- after surgery start to eat healthy, well balanced diet. And follow the instruction of the
doctor and consult regularly.
Shower - that is possible and safe to give bath to the patient at home after releasing from the
hospital an the basis of healing of wounds. Long time wetness is can be harmful so avoid soaking of
body for long time, padding and removal of wetness is necessary. (Wang and et. al., 2017).
workout and yoga – yoga, meditation and some normal smooth exercise is can be very helpful in the
improvement of internal and external activities of body. These workout will help in the improvement
of physiological system of patient body and relaxation of mind.
Resuming sexual relation- the anxiety and stress reduces the sex drive.
Going back to work- when the body is ready to go for work then firstly start to do work for a
short day or half time. When body and part of surgery seems fine then create regularity in work
section.
Follow up- for cancer patient, between 3-4 weeks after the release from hospital of patient with the
colon cancer nurses.
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DEMONSTRATES THOROUGH AND CRITICALLY DISCUSSION ON
NURSING MANAGEMENT FOR MADAM K CREATIVELY
INCLUDES RELEVANT AND SPECIFIC EVIDENCE.
Nursing management related with the patient's convenience that proper management
should be applied for their patient after the treatment. The patient's should know more and more
about their diagnosis and care for their betterment. There are some interventions which need to
be there (Maillet and et. al., 2016).
Initial phase
There is an eHNA data which is known as Holistic Needs Assessment. It is available
electronically which help in identifying the needs and concern of the patient's. Diagnosis and
early interventions are also can be identified which is going to have due to side effect. They need
to learn about the better life-style and diagnosis should be there at right time so that there should
not any complications. This makes the health good after this can help in better recovery. There
should not be any misconceptions regarding the care and diagnosis. Any misconceptions can
cause wrong effect or any bad impact on the patient's health. The patient's should addressed to
cognition including mental status regarding their new diagnosis and needed to help for overcome
through the learning blocks.
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Illustration 3: surgical management

They need to explain about their problem which is colon cancer and related to its
symptoms in full detailed. They need to explain all details in simple language without using the
medical jargon or say medical terminology because patient's are not aware of such jargon and
needed to explain as simple so that everybody can understand it easily. Nursing staff should
explain the pathophysiology of colon cancer in the most possible simplest way.
Nursing staff should have elaborated about the treatment and their complications or their
possible side effects which is common in some cases or sometimes not. Before treatment
patient's has already be informed about this so that can deny any informed consents. HNA can be
use in different gadgets like pc, smartphones, tablets and on any web browsers (Vong, L.B. and
Nagasaki, Y., 2016).
Nursing staff need to show the Patient's Experience Survey of Colorectal Cancer. This survey
can help in built the confidence in them and help in their mentally progression in their mind. This
data explains that only few say less than 13 % are having side effects and less than 11% are
facing day to day impact of cancer. They need to explain to build confidence in patient's that
patient's have rated 8 to 10 out of 10 which is more than 80 %.
Quality of life should be explained so that they can get motivate instead of lowering their
expectation of care.
Fatigue
Fatigue is one of the most reported in terms of symptoms after surgery of cancer. It is
raised as a complex combination of not clearly understanding of physical and psychological
effects in term of sick which can be seen different in different type of patients. It can also caused
due to not completing the sleep in night. This can also be caused due to decreased motivation in
the patient's. The obesity is on of the major problem of many disease while in surgical operation
the fatty people feels more fatigue then normal (Padmanabhan and et. al., 2019)
Pain
There is an estimation of approx one third of the patients having active treatment for
cancer experiencing pain. The pain are not fully run off by using analgesics or other therapies.
Pain can even there if there is no sign of any cancer in the patients which may be confusing that
this is due to the treatment or its just an obvious.
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Limiting daily living activity
Daily life activity which is done in regular basis and Fatigue and pain is experienced by
them but the neglect it as normal. This included such type of activity that he or she need to do it
for themselves and cant be altered or changed due to their habituations. For Madam K, such
activities which in include as bathing, using wash room, preparing breakfast, lunch, dinner,
movement to outside for grocery shopping, paying bills, standing in queue for her turn and using
public transport or own transport or vehicle etc. This includes as a quality of life which is
normal and for high quality life there should be there any one who can care of them so they don't
need to work hard by own and have their work should be done with the help of other which one
is there for help her but it Siegel and et. al., 2017can also be taken in mind that anyone is not
available all the time with her so need to do some of her work on her own.
Tingling in limbs
There should tingling in limbs can be there which is general cause of excitation but in cancer
patient this can be seen as a common side effect which may lasts for a couple of months which
can be finishes after treatment or may be permanent there. Nursing staff should advise her to
check the temperature of water in her home for avoiding burns. She need to advised to use the
gloves in her limbs for doing her household works. She need to wear non-slippery shoes or
footwear to avoid slip. Needed to check-up your limbs if there is any injuries. Due to this during
driving she may not feel the paddles which can be cause of any accident so advised to have
someone who can drive for her.
Telephonic enquires
They should informed that they are going to enquired by the nursing staff on regular basis
by the phone regarding their health issues which shows the caring of the patient's after the
treatment and can have sign of good caring for her. Telephonic enquires may include their
normal lifestyle and does and don't of their routine, any health related issue and some effect on
the health due to any reasons. The doctor or nursing staff have must know about the patient
condition. Its no majorly possible to attend regular so telephonic is only medium to update the
patient health issue (Sattar and et. al., 2018).
CONCLUSION
As we discussed above, colon cancer is generally located in the intestine part of the body.
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As per the condition the colon cancer patient ( madam k.) facing a lot of problem after surgery.
Patient have must know the circumstances and total awareness by consulting her Physiological
alteration to the consulting doctor. The doctor or a nursing staff provide every management and
treatment process in brief to the patient. Doctor needs to give an alert as a warning to the patient
about what she do or not. The nursing staff must had a specific knowledge about the managing
scale and scenario of the colon cancer. There may some complications or say side effect which
can be there after the treatment which can be customised with later on treatment and can be
solved. Some of the side effect can have a chance to leave for life time which have a few chances
and those can be managed easily on the daily basis. Nursing staff should provide the brief
knowledge about related to their care and health concern which should be in the normal language
, so anybody can reality understand it on their basis knowledge and there should not be any
medical terminology used.
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REFERENCES
San Hipólito-Luengo and et. al., 2017. Dual effects of resveratrol on cell death and proliferation
of colon cancer cells. Nutrition and cancer, 69(7), pp.1019-1027.
Araghi and et. al., 2019. Global trends in colorectal cancer mortality: projections to the year
2035. International journal of cancer, 144(12), pp.2992-3000.
Siegel and et. al., 2017. Colorectal cancer incidence patterns in the United States, 1974–2013.
JNCI: Journal of the National Cancer Institute, 109(8).
Manerba and at. al., 2017. Lactate dehydrogenase inhibitors can reverse inflammation induced
changes in colon cancer cells. European Journal of Pharmaceutical Sciences, 96, pp.37-
44.
Saitoh and et. al., 2016. Management of colorectal T1 carcinoma treated by endoscopic
resection. Digestive Endoscopy, 28(3), pp.324-329.
Wang and et. al., 2017. Safety, quality and effect of complete mesocolic excision vs non‐
complete mesocolic excision in patients with colon cancer: a systemic review and meta‐
analysis. Colorectal Disease, 19(11), pp.962-972.
Maillet and et. al., 2016. Early postoperative chemotherapy after complete cytoreduction and
hyperthermic intraperitoneal chemotherapy for isolated peritoneal carcinomatosis of
colon cancer: a multicenter study. Annals of surgical oncology, 23(3), pp.863-869.
Vong, L.B. and Nagasaki, Y., 2016. Combination treatment of murine colon cancer with
doxorubicin and redox nanoparticles. Molecular pharmaceutics, 13(2), pp.449-455.
Padmanabhan and et. al., 2019. Folate/Vitamin B12 Supplementation Combats Oxidative Stress-
Associated Carcinogenesis in a Rat Model of Colon Cancer. Nutrition and cancer,
71(1), pp.100-110.
Sattar and et. al., 2018. Chemotherapy and radiation treatment decision-making experiences of
older adults with cancer: a qualitative study. Journal of geriatric oncology, 9(1), pp.47-
52.
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