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Case Study 1: Mr Robert Andrews is 67 years of age. He has been transferred from ICU following a bowel resection of the descending colon for bowel cancer four days ago. He has developed a cough.
Consider the patient:
• Provide statistics for the incidence of bowel cancer in Australia
• Identify the risk factors for bowel cancer
• Link these facts to the patient in the case study
• Explain the clinical manifestations (signs and symptoms) of bowel cancer – briefly link these to some pathophysiology
Collect cues/information/process information
• Determine four possible aetiologies (causes of the problem) for Mr Andrews' cough and justify each choice
• Chose two of the most likely aetiologies and justify the choices
• Explain what subjective and objective assessments would be required to determine each of the two aetiologies and explain why each assessment would be undertaken
• For each of the two aetiologies identified above, if no nursing actions were implemented, what could happen to Mr Andrews?
Identify problems/issues/take action
• Explain the nursing actions/interventions would be required for the two aetiologies and explain why you would be implementing these actions
• What are the most important things that you have learned from this scenario?
• What actions will you take into clinical practice as a result of your learning from this scenario?
Mr Robert Andrews is 67 years of age. He has been transferred from ICU following a bowel resection of the descending colon for bowel cancer four days ago. He has developed a cough.
Description of the Case Study
Mr Robert Andrews is 67 years of age. He has been transferred from ICU
following a bowel resection of the descending colon for bowel cancer four days
ago. He has developed a cough.
Description and Statistics of Bowel cancer
The above case study indicated that Mr. Robert was suffering from bowel cancer. Bowel Cancer refers to the cancer of the colorectal region. This type of cancer is also called colorectal cancer and it is the 2nd most common type of cancer which is prevalent in Australian men and women. Colorectal cancer is most prevalent above the age of 50 years. The carcinoma occurs in the inner lining of the bowel and is often accompanied by small outgrowths (polyps) within the bowel. However, polyps may be benign or malignant. The malignant polyps invade the adjacent tissue through metastasis andlead to the genesis of colorectal cancer. Around 14,957 new cases of bowel cancer were diagnosed in Australia during 2012. The number of new cases of bowel cancer detected in 2016 has already reached 17,250 (9815 males and 7707 females). Bowel cancer accounted for 13.6% cases of all cancer episodes in 2016 (Table 1) and it remains the 2nd prevalent cancer type in Australia. The risk of suffering from bowel cancer is 1 out of 11 (in men) and 1 out of 15 (in women) by the age of 85 years. The age-specific prevalence of bowel cancer is represented in figure 1. Till date, 4000 cases of mortality (during 2016) due to bowel cancer have been registered in Australia (Australian Institute of Health & Welfare 2016).
Risk Factors for Bowel cancer
The different risk factors for bowel cancer are inherited and genetic risk of incurring the disease, untreated inflammatory bowel disease, consumption of high amounts of red meat (mainly processed meats), and overweight/obesity, history of excessive smoking or alcohol consumption and age of the individual. It is possible that Mr Robert had a familial risk of incurring bowel cancer, might have a prevalence of untreated inflammatory bowel disease, and he may have consumed high amounts of red meat during his entire lifetime. Since the age of Mr Robert is over 50 years, it might also lead to the genesis of colorectal cancer (Australian Institute of Health & Welfare 2016).
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