Case study

Case Study

Oluwaseun Banjo

Herzing University

NU 208 Pathophysiology

Prof. Carie Johnson

History

JA is an 82-year-old, African American male that was transferred to the emergency department after being noticed with nausea, vomiting and weakness at where he was being monitored at Elevate Care Riverwood nursing home and Rehabilitation center for 7 days following discharged at the hospital for a diagnoses of Colon Cancer stage 4. JA has a medical history of Rheumatoid Arthritis, Coronary Artery disease with a placement of stent, kidney disease stage 2, hypertension, and heart failure. JA resides at home alone and planning to move into a senior living facility. He is a retired school janitor. JA is divorced and has 5 grown children.

Nursing Assessment

Upon arrival to the emergency unit, JA was noted to be very confused, very weak, and lethargic. Vitals upon arrival was Blood pressure 132/67, tympanic temperature 98.5, Room air oxygen saturation of 96%, Pulse 71, and Respiration 19. Heart sound was regular, Pulse was noted thready and weak, Breath was regular and normal. He was noted with electrolytes imbalance of Potassium of 2.4, Sodium of 129 and calcium of 7.2. JA was transferred for the Intensive care unit for further evaluation on his Colon Cancer and electrolyte replacement.

Pathophysiology

Colon cancer begins with as a small benign clump that form on the side of the colon and later become cancerous. Colon cancer typically begins in the large intestine which is the last/final part of the digestive tract. Another term for Colon cancer may be known as Colorectal cancer, which in term is a combination of rectal and colon cancer starting from the rectum. Colon cancer may be observed with no symptom in early stage while symptom may vary due to different stages. Some symptoms are persistent change in bowel habit, blood in the stool, Abdominal discomfort, weakness or fatigue and unexplained weight loss. Risk factors are old age, Race (African American), history of colon cancer or polyps, Inflammatory Intestinal condition, hereditary, Low-fiber/High-fat diet, Obesity, Smoking, Alcohol, and radiation therapy. Other past diagnoses were well managed with medications and regular checkup.

Treatments

JA will be receiving IV fluid to replenish from lost of fluid. He might be undergoing colonoscopy to remove some polyps which depends on the doctor’s decision. In some other cases to minimize invasive surgery due to JA’s age, he could be going through laparoscopic procedure. For more advance Stages, a partial colectomy or ostomy might be in consideration. Some lymph node might be removed for testing. Blocking of some section of the colon might be used depending on how worse the colon is damaged or the stage if the cancer. Chemotherapy, immunotherapy, or radiation therapy can also be use depending on how the patient can tolerate the treatment. Supportive (palliative) care can also be a consideration for comfort or pain management. A nurse’s role is to provide treatment and comfort regime during any process that comes with the doctor and patient’s decision. Prior to this, JA needs to be relieved of his condition of weakness, vomiting and nausea.

Reference

King T. E., Jr (2005). Clinical advances in the diagnosis and therapy of the interstitial lung

diseases. American journal of respiratory and critical care medicine, 172(3), 268–279.

https://doi.org/10.1164/rccm.200503-483OE

Johnson, M (2012). NOC and NIC Linkages to Nanda-I and Clinical Conditions. Bookshelf Ambassadored, 155-166. Retrieved From https://ambassadored.vitalsource.com/#/books/978-0-323-07703-3/