T12: Lower GI & Colon Cancer

Question 1

appendicitis

Answer 1

inflammation of the appendix, located in the inferior part of the cecum

Question 2

clinical manifestations of appendicitis

Answer 2

o Dull periumbilical pain, anorexia, nausea and vomiting
o Pain becomes persistent and localizes between the umbilicus and right iliac crest known as McBurney’s point
o Client usually prefers to lie still, often with the right leg flexed

Question 3

McBurney’s point

Answer 3

Pain becomes persistent and localizes between the umbilicus and right iliac crest, when examiner pushes on this area pain is relieved, when area is release there is a lot of pain

Question 4

diagnostics for appendicitis

Answer 4

o Complete history and physical exam
o CBC with differential
o Urinalysis (to rule out UTI)
o CT scan (preferred), MRI

Question 5

intervention for appendicitis

Answer 5

o Treatment is aimed at preventing peritonitis and removing the appendix, GET IT OUT QUICK!
o Keep client NPO until HCP evaluates for surgery

Question 6

If pain suddenly disappears it could mean …

Answer 6

it perforated

Question 7

Post op appendectomy

Answer 7

o NPO
o NG to low intermittent suction
o Semi-fowlers position
o IV fluids with electrolyte replacement
o Blood transfusions as needed
o Antibiotics

Question 8

peritonitis

Answer 8

results from a localized or generalized inflammatory process of the peritoneum

Question 9

primary peritonitis

Answer 9

blood borne organisms enter peritoneal cavity

Question 10

secondary peritonitis

Answer 10

abdominal organs perforate or rupture spilling into the peritoneal cavity

Question 11

clinical manifestations fo peritonitis

Answer 11

o Abdominal pain
o Tenderness over the involved area
o Rebound tenderness
o Abdominal muscular rigidity and spasm
o Abdominal distention
o Fever, tachycardia, tachypnea, nausea and vomiting

Question 12

complications of peritonitis

Answer 12

o Hypovolemic shock
o Sepsis
o Intra-abdominal abscess formation
o Paralytic ileus
o ARDS
o Peritonitis can be fatal if treatment is delayed

Question 13

diagnostics for peritonitis

Answer 13

o CBC with differential
o Electrolytes
o Abdominal X-ray
o CT scan or ultrasound

Question 14

management for peritonitis

Answer 14

o NPO status
o IV fluid replacement
o NG to low intermittent suction
o O2 PRN
o Drug therapy
o ANTIBIOTICS
o Analgesics
o Antiemetics

Question 15

Colorectal caner risk factors

Answer 15

more common in men, highest mortality in African American men and women, risk increases with age

Question 16

LYNCH SYNDROME

Answer 16

SPECIFIC GENETIC FORM OF CANCER
IF FAMILY MEMBER HAS IT, OTHERS MAY HAVE IT TOO
hereditary nonpolyposis colon cancer, DNA repair genes messed up p96

Question 17

clinical manifestations of colorectal cancer

Answer 17

o Insidious onset
o Symptoms often do not appear until disease is in advanced stages
- Change in bowel habits
- Unexplained weight loss
- Vague abdominal pain
- Rectal bleeding is most common (bright red bleeding)
- Alternating constipation and diarrhea
-Change in stool caliber
· Narrow, ribbonlike, color
- Sensation of incomplete evacuation

Question 18

screen ing for colorectal caner

Answer 18

Regular screening for polyps and cancer from ages 50 to 75 years of age

Question 19

colonoscopy every

Answer 19

10 years

Question 20

Flexible sigmoidoscopy, Double-contrast barium, CT colonography every

Answer 20

5 years

Question 21

High-sensitivity fecal occult blood test (FOBT)

Answer 21

stool specimen for occult blood

Question 22

Fecal immunochemical test (FIT)

Answer 22

· Test for blood in the stool
· Must be done frequently to catch intermittent bleeding common with tumors

Question 23

gold standard diagnostic for colorectal cancer

Answer 23

colonoscopy

Question 24

clear liquid diet

Answer 24

a diet that consists of foods that are liquid at room temperature and leave little residue in the intestine. Ex: Water, Sprite, Ginger Ale, all beverages without any residue, broth, Jello

Question 25

CARECINOEMPRIONIC ANTIGEN (CEA)

Answer 25

MARKER FOR CANCER, WILL NOT TELL YOU WHAT KIND OF CANCER BUT TELLS YOU THAT CANCER IS PRESENT

Question 26

stage 0 colorectal cancer

Answer 26

cancer has not grown beyond inner layer of colon wall

Question 27

stage 1 colorectal cancer

Answer 27

grown to outer layer of wall

Question 28

stage 2 colorectal cancer

Answer 28

tumor is through wall, not spread to lymph nodes

Question 29

stage 3 colorectal cancer

Answer 29

cancer
spread to lymph nodes

Question 30

stage 4 colorectal cancer

Answer 30

cancer spreads to distant sites in body such as liver or lung

Question 31

surgical therapy for colorectal cancer

Answer 31

-polypectomy
-may need colostomy
- chemo and radiation

Question 32

COLONIC J-POUCH OR COLOPLASTY

Answer 32

CREATE AN ALTERNATIVE RESERVOIR THAT REPLACES RECTUM AS A RESERVOIR FOR STOOL
o The anal sphincters remain
o Temporary colostomy allows for healing

Question 33

Stoma appearance should normally look

Answer 33

pink or red and moist/red and beefy

Question 34

ileostomy stool

Answer 34

stool with be more thin/liquid

Question 35

Colostomy stool

Answer 35

stool will be more formed