Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 320 (mcp) > Colorectal Cancer > Flashcards

Colorectal Cancer Flashcards

1
Q

Colorectal Cancer is the ___ leading cause of death in the ____ bowel.

A

2nd leading cause of death in the large bowel.

1/21 chance :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common location & type of Colorectal Cancer:

What forms first and can turn into cancer?

A

Rectosigmoid region

Adenocarcinoma

Polyps → Cancer

Often metastasize…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s the weird way Colorectal Cancer can metastasize?

A

Seeding

- Surgical removal of cancer, but a little bit of cancer drops into the abdominal area and start to grow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complications associated with Colorectal Cancer: (5)

A
  1. Bowel obstruction
  2. Bowel perforation
  3. Abscess formation
  4. Fistula Formation
  5. Bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nonenvironmental Risk factors associated with Colorectal Cancer (4)

A
  1. Age (>50)
  2. Genetics
    - Crohn’s Disease
    - Familial Adenomatous Polyposis
    (I have this…..)
    - Ulcerative colitis** (very high risk)
  3. John Cunningham virus
  4. Human Papilloma Virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Environmental Risk factors associated with Colorectal Cancer (5)

A
  1. Smoking
  2. Obesity
  3. Sedentary lifestyle
  4. Heavy Alcohol Consumption
  5. Low-fiber, High-fat diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Colorectal Cancer + Screening

Recommended Age for AVERAGE risk?

A

Average risk: 45 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Colorectal Cancer + Screening

Recommended Age for HIGH risk?

A
  1. Before 45
    OR
  2. 10 years before 1st-degree relative was diagnosed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q 
Colorectal Cancer + Screening 
Screening tests (4)

What is the Gold Standard for Screening?

What other testing should be done for someone who is high risk?

A
  1. Colonoscopy*** → GOLD STANDARD
  2. Fecal Occult Blood Test (FOBT)
  3. FIT-DNA Test
  4. Double Contrast Barium Enema
    * *don’t need to know #’s 2-3**

Genetic testing
(good thing I got life insurance before I did this lol….)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Colorectal Cancer + Screening

How often should someone with Crohn’s Disease (or ulcerative colitis?) be screened?

A

annual colonoscopy

also tells us if the disease is being managed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Colorectal Cancer + Assessment

What are the 3 Most Common Findings?

A
  1. Rectal bleeding
  2. Anemia (low Hgb)
  3. Changes in stool habits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Colorectal Cancer: Pt History & Assessment

What S/S would we want to ask about?

A
  1. Changes in Bowel Habits
  2. Changes in Stool (texture, shape, color)
  3. Pain
  4. Abdominal Fullness
  5. Fatigue
  6. Weight Loss
  7. Distension
  8. Palpable Masses (AP assessment)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Colorectal Cancer: Assessment

What are the 2 main things we are assessing? (broad)

A
  1. Rectal bleeding + characteristics

2. Presence/Absence of blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Colorectal Cancer + Assessment

Rectal bleeding characteristics

A
  1. Trace or Gross amounts
  2. Color
    - Mahogany (will never look at it the same)
    - Bright red (frank)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Colorectal Cancer + Assessment
Blockage assessment:

Most common the ___ and _____ colon

What are 3 General S/S?

A

Most common in transverse and descending colon

  1. Gas Pains
  2. Cramping
  3. Incomplete Evacuation

VERY PAINFUL!! (severe abdominal pain)

17
Q

Colorectal Cancer + Blockage Assessment

Partial Bowel Obstruction S/S (2)

A
  1. Visible Peristaltic Waves

2. Tinkling/High-pitched Bowel Sounds

18
Q

Colorectal Cancer + Blockage Assessment

Complete Bowel Obstruction S/S (1)

A
  1. Absence of Bowel Sounds
19
Q

Colorectal Cancer + Assessment

Hematochezia (Frank blood), straining, and narrowing stools are characteristics of ______ colon cancers.

A

Rectosigmoid Cancers

lower GI

20
Q

Colorectal Cancer + Assessment

Gross amounts of Mahogany-colored stools, anemia, and a palpable mass are characteristic of ______.

A

Right-sided tumors r/t colon cancer

21
Q

Colorectal Cancer + Diagnostics
Gold Standard?

Other INVASIVE Tests (4)

A

COLONOSCOPY

Others:

  1. CT
  2. CT-guided virtual colonoscopy
  3. MRI
  4. Sigmoidoscopy
22
Q 
Colorectal Cancer + Diagnostics 
Blood test (3)

Stool test? Any Disadvantages?

A 
Blood tests:
1. HH
2. Liver Enzymes
3. Carcinoembryonic antigen (CEA)
(CEA doesn't tell you shit... high sensitivity, low specificity)

Stool test:
1. FOBT
→ LOTS OF FALSE NEGATIVES
- precancerous polyps don’t bleed

23
Q

Colorectal Cancer + Tx Interventions (3)

A
  1. Surgery: Colon Resection
  2. Radiation Therapy
  3. Chemotherapy

(Comfort….. good booty)

24
Q

Colorectal Cancer + Surgery
Goal?

Surgery approach depends (5)

A

Remove diseased Tissue

Depends on:

  1. Size of tumor
  2. Location of tumor
  3. Extent of disease
  4. Condition of colon
  5. Condition of patient (can they tolerate it)
25
Q

Colorectal Cancer + Surgery

3 types of surgeries:

A
  1. Colon resection
  2. Colectomy
  3. Abdominoperineal resection
26
Q

Colorectal Cancer + Surgery

Colon resection is

A

just removal of a section of the colon

27
Q

Colorectal Cancer + Surgery

3 Types of Colectomies

A
  1. colostomy
  2. ileostomy
  3. ileoanal pull-through

When a piece of the colon is diverted through an opening in the abdominal wall in order to bypass part of the colon.

28
Q

Colorectal Cancer + Surgery
What’s different about a mucosal fistula?

What about an ileoanal pull-through

A

TWO stomas

NO stoma

29
Q

Everybody POOPS, tell me about it for:
Ascending colostomy:

Transverse colostomy:

Descending colostomy

Ileostomy?

A

Ascending → Liquid (thickens a little over time)

Transverse → Pasty

Descending → Formed/Solid

Ileostomy → Liquid

30
Q 
Colorectal Cancer + Surgery
Preoperative Considerations (4)
A
  1. WOCN referral
  2. Bowel Prep (poop, poop, & more poop)
  3. Pre-op Antibiotics
  4. Education
31
Q

Colorectal Cancer + Surgery
Postoperative Considerations (5)
What will they need?

A
  1. NG tube (out of ur butt, & down ur throat)
  2. IV PCA (paaaaain, my ma got ketamine)
  3. NPO
  4. Colostomy care
  5. Wound management
32
Q

Colorectal Cancer + Colostomy Care

Tell me ‘bout a NORMAL Colostomy

A
  1. Beefy red (reddish-pink)
  2. Skin intact
  3. Budded/Protrudes ~3/4 above the skin
    (Not retracted or prolapsed)
33
Q

Colorectal Cancer + Colostomy Care

What would you expect 1-day post-op?

When should it start shootin’ in poopin’ post-op?

How often should we assess the Colostomy and Colostomy pouch?

A

1 day post-op: serosanguinous drainage

Should be working in 2-3 days post-op

Assess color + pouch every HOUR

  • esp. after surgery for color and drainage
  • watch out for gaaaaasssss
34
Q

Colorectal Cancer + Colostomy Care

Patient Education:

A
  1. Equipment
    - Pouch System/ Appliance
    - Measure Stoma 1x weekly for 6-8 weeks
    - Cut wafer 1/8-1/16” larger than stoma
  2. Skin Prep
    - Clean with mild soap and water
    - DRY the area well
  3. Avoid Gas/odor-causing foods
    -
35
Q

Colorectal Cancer + Surgery
Abdominoperineal resection:

Common with what kind of colon cancers?

A

The entire rectum is removed

  • Stoma
  • Large wound in the perineal area

Rectosigmoid colon cancers

36
Q

Colorectal Cancer + Surgery
Abdominoperineal resection:

Biggest concern?

What kind of pain may they experience?

What are they at risk for?

A

WOUND MANAGEMENT

  1. Monitor Drainage
  2. Jackson Pratt (JP) Drains
  3. Manage Discomfort
  4. Rectal Pain & Itching
    - “Phantom butt pain” (literally spoopy)
  5. HIGH Risk for Infection!!
37
Q

Colorectal Cancer + Post-acute Surgical Care

Who can help with this? (referrals)

A
  1. Home health
    - Case Management referral
    - Wound care Mx
  2. Radiation and/or chemotherapy
    - Oncology Navigators
  3. Palliative** or Hospice care
38
Q

Colorectal Cancer + Expected Outcomes (5)

A
  1. Effective Coping
  2. Progression through stages of grieving
  3. Comfort (physically & mentally)
  4. Stop Spread of Disease
  5. Able to perform self-care with colostomy

NSG 320 (mcp) (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions