Colonic cancer is one of the most common cancer that is found in the elderly women across the globe. Eleanor Wilson is a woman who has severe problems in her abdomen since three months. When she was interrogated with her general practitioner and with the help necessary interventions the clinicians came to know that she might be having any colon deformities. She may be having any type of colon cancer. The following part of the essay describes about the proper guidance that should be required to understand the medical conditions of the patient. Patient assessment tools and the intervention program should be used to respond the assignment questions. Furthermore, the patient is 78 years old so, proper medical history of the patient is required. The surgical procedures and the colonoscopy or any other tests which are needed to be performed should be done efficiently (Bonjer et al., 2015).
Most people do not face any type of difficulties after the colon operation. They often recovered from the surgery without any problems. A very small number of patients can face many difficulties and they’re advised to stay in the hospital for some days. A short hospital stay is very much effective to the patient who are having laparoscopic surgical incidence. Prioritising of care needs to be done to enable the critical thinking than direct questioning to the patient.
Potential four issues
1) The nurses and the clinicians should interact with the patient because patient is the main source of information.
2) The clinicians should ask the patient to rate on 0 to 10 on the required problem.
3) The nurses should ask the patient about their food habit.
4) Nurses should encourage the patient to visit the PCA.
5) The patient should be asked that whether she feels exhausted or tired after the operation.
1. Unrelieved pain.
2. Trouble in eating
4. Bleeding can occur in the patient.
1)Interaction with the patient is required to understand the exact location of the pain.
The pain detection machine or the tools should be used (Lawrence et al., 2013).
2) Nasogastric tube may be used.
Nurses and the family members should make the patient comfortable in eating.
Saline can be provided to the patient.
The patient should stay on a liquid diet.
3) Nurses should treat the patient to perform certain exercises.
The patient should not stay too long on the bed and the patient should walk on the floor with proper help.
4) Supportive care should be given to the patient.
Blood test should be done to understand the RBC count so the need of blood transfusion should be understood.
1)Pain can be initiated after the operation for many reasons. Maybe the body is not permitting or some problems may occur during the operations (Syrjala et al., 2014).
2) Medicine and surgery can cause this. Food and drinks move slowly from the intestine so pain can occur.
3) The common problem is the infection because the colon is not clean.
The patient can also face the lung infection due to resting too much in bed.
4) After the colon operation many reports have been seen the abnormal discharge of blood from the body (Frasson et al., 2015).
The blood flow can start with 24 hours of the operation.
Mrs Eleanor is 78 years of age and had numerous problems. Previously she had hypercholesterolemia which means a high level of cholesterol in the blood. Increased level of cholesterol in blood can cause obesity problems and cardiovascular problems. She dealt with hypertension because her daughter is a divorcee. She lived with her two daughters and due to her age factor she felt very much mentally depressed. The co-morbidities which occurred with the patient is that she is a smoker and she usually smokes two cigarettes per day. Due to her smoking habit she faced asthma problems in her lifestyle, which is relieved by the puffer. The four potential clinical issues that can be occurred after the operative stage includes problems in eating food, unrelieved pain still in the abdomen, infection and bleeding from rectum. The prevalence of comorbidity, cancer and diabetes and especially of cardiovascular disease was highest in the ascending colon. According to the case study the ascending colon was operated and due to this she felt pain in her abdomen. The occurrence of colon cancer has enlarged in many years. With the increasing age of the patient who is 78 years old the occurrence of the disease will increase gradually and very hard to recover with the help of colon surgery. Unluckily, ageing patient who develop colon cancer have a co-morbidities like pulmonary diseases and cardiovascular diseases, which upsurge the risk of operation and the risk of postoperative mortality and morbidity. However, the factors which contribute to poor result of surgery in the patient are postponed presentation and more sickness. So, healing surgery of colonic cancer in elderly patient is arguable, especially in the very old patients like Mrs Eleanor, who have limited chance of existence. Some clinicians or doctors suggests extensive surgery, which includes multistage procedures and it is performed in younger patients and the adult patients encourage less belligerent surgeries. In the colon cancer patient, co-morbidity and age are analysis of survival. This hardens the circumstances that despite the mortality and morbidity rate related with a colon cancer diagnosis, standard patient appearances still predict a primary outcome of the patient. This shows the necessity to treat the patients comprehensively. The anaesthetics were given to the patient to decrease the pain in the abdomen. General anesthesia with short-acting medications and without premedication is a more fast rising up out of the analgesic state, together with particular myorelaxant opponents to block post-agent remaining loss of motion, respiratory confusions, and diseases. General anesthesia, related with locoregionalanesthesia at whatever point conceivable, offers numerous favourable circumstances. Utilizing neighbourhood analgesics (fringe nerve or plexus squares, epidural or spinal anesthesia) within medical procedure decreases the measure of morphine required and gives better torment control. On the off chance, that the implantation of liquids had been controlled amid medical procedure to stay away from their over-burden, numerous tissues would be less edematous, and the careful anastomosis would be better saved. Truth be told, intravenous crystalloid liquids venture into the interstitial volume, as opposed to into intravascular space, amid careful pressure so the patient ought not to need to endure torment. Pain after medical procedure is "modified" and destructive, and it must be estimated and treated to keep away from, at whatever point conceivable, the utilization of morphine. The multimodality approach can prompt better torment control and block confusions. Without torment the post-medical procedure, nervousness, and distress will be diminished. An audit of the pathophysiology, clinical introduction, and conclusion of colon growth and colonic polyps is critical and convenient for the clinicians and the medical care doctors. The medications which are given to the patient are the paracetamol, aspirin was also administered to relieve the pain after the surgery. Many type of analgesics can be prescribed to the patient but the nurses or the doctors should clinically detect the condition of the patient before the medication. The positive relationship between low comorbidity drug adherence and the quantity of unfortunate days recommends that tending to obstructions to comorbidity prescription adherence amid disease treatment might be a pathway for enhancing or keeping up the colon cancer patients and comorbid conditions.
Nursing interventions- The nurses should have a knowledge into every patient's understanding of their sickness, treatment and reactions. They should provide data and instruction to the patient and families. The nurses should be the purpose of contact for them. The nurses should act to the greatest advantage of the patient and their family to help organize the analysis, treatment and after-mind of a patient with colorectal cancer. The nurses should represent the patient's psychosocial needs and inclinations inside the multi-drug therapy. Nursing intervention is required for Mrs Eleanor because this will help the patient about screening and early detection of the symptoms (Davis et al., 2013). It will encourage the patient to recognise the certain actions and their respective care measures that will eventually promote the patient’s comfort and relaxation. Moreover, the nursing interventions eventually prepares the patient like Mrs Eleanor for the unfavourable effects of the chemotherapy and what are the required steps should be taken to minimize the effects chemotherapy.
Discharge planning- The patient will be released from the care unit when she is ready to drink the greater part of the fluid that her body needs without feeling drained. Besides, dealing with the pain with the pills and furthermore when the patient can ready to get up from the bed and walk without help then the patient is ready to go home. The other problems that can occur after the surgery includes the allergy on medications, heart problems due to blood clot and also the incomplete healing of the part of the colon which was removed. It is seen that cancer patients are pleased with the excellence of the technical care which they receive. However, they are less gratified with the other terms of the care which includes supportive services and the communications. Psychosocial care is one of the priority cares that are required to expand consumer inclusion in all phases of malignancy control. High levels of psychosocial and physical issues are experienced by the malignancy patients (Antoni, 2013). The arrangement of treatment, test and prognosis are an issue. Research demonstrates that requirements of the cancer patients for evidence about their sickness, its cure and their visualization are not being as of now met. Cancer patients have shown that they don’t know much about the likelihood of the disease distribution, facing the tremendous agony and enduring, adapting to tensions identifying with having treatment, and staying aware of work responsibilities. Clinicians or the doctors tend to think little of the information about their patients’ desire and they miscalculate the measure of time spent giving that information. Given the central role that information has in enabling people to be dynamic members in decision making, and in fulfilling medico legal prerequisites, such discoveries are of concern and demonstrate the requirement for effective action. The cancer patients raised the concern about the evident absence of acknowledgment of the requirement for supportive care in tumour control. Clinical administration of colon tumour underlines the requirement for the growth experts to give proper and satisfactory support. This incorporates being offered sufficient advising; access to help support groups and required practical assistance. This psychosocial support has been initiated to affect the patient's personal satisfaction, enthusiastic change, social working, information levels, adapting abilities and even their illness and treatment related manifestations. After the post discharge the patient must visit to their respective clinicians to understand the present condition of the patient (Keller et al., 2014). The patient may be recommended further for the chemotherapy and the patient should collaborate with her respective oncologist. Patient education is the process by which the health care professionals and the caregivers should give proper education to the colon cancer patient and they should educate the patient about the necessary steps that are required for the patient. According to NHPA the patient should be asked to eat healthy foods, to consume the medicines which was prescribed by the doctors and the most important is that the patient should check her bowel movements (Aihw.gov.au, 1998). The wound of Mrs Eleanor may not have fully healed before she went home so if she still needs a wound dressing then the general practitioners or the nurses should guide her. It is quiet safe for the wound to get wet when the patient went to her home. The wound should be perfectly patted dry. According the case study the nurses and the general practitioners should encourage Mrs Eleanor to perform gentle exercises in order to build up the strength of the muscles. She should start going for a short walk daily and gradually it should be increased. The nurses should take care of Mrs Eleanor during bending stretching or lifting especially within the first few weeks of surgery.
It can be concluded hereby that Mrs Eleanor had undergone colorectal operation because she was having problems for many days. Therefore she had undergone a colorectal surgery and she had undergone midline incision and occlusive dressing. She was admitted to the post-operative active care unit for recovery and then she was shifted to the general ward. The PACU is the critical care unit where the vital signs of the patient should be properly observed. The first 24 hours following the surgery is very important and proper care should be taken for the patient within this first 24 hours. The nurses and the general practitioners should take care of the patient properly and if any medical emergencies occurs then they should provide the acute care to the patient. Colonoscopy is the most operative tool to understand and is used to visualise the internal structure of the colon. According to the case study the patient should be provided with proper education on the illness. Physicians, general practitioners or the clinicians have an important role in the patient education in order to ensure the safety and the effective patient care. Patient education process should enable Mrs Eleanor to improve her health by alternating the health related behaviours.
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