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Faulkner State Community College; Division of Nursing

NUR 201
Clinical Paperwork Data Sheet

Student Name___________________________________ Clinical Week_______________________________

Date _____________ Client Initials__________ Age _______________ Admission Date ______________

Instructor_______________________________________ Clinical Area ________________________________

Medical Diagnosis and Pathophysiology: (Be sure to list signs and symptoms). Please indicate your
source of information.

The patient has colon cancer of the liver. The patient has had 4 partial gastrecomies, and a liver resection
of the left lobe. Ninety-five percent of colorectal cancers are adenocarcinomas. Adenocarcinomas are
tumors that arise from the glandular epithelial tissue of the colon. Most colorectal cancers develop first as
colorectal polyps, which are growths inside the colon or rectum that may later become cancerous.
Colorectal cancer can metastasize by means of direct extension or by spreading through the blood or lymph.
The liver is the most frequent site of metastasis from circulatory spread. Of clients with colorectal cancer,
metastasis to the liver develops in 15% to 30% even with surgical resection of the tumor. Colon tumors can
also spread by peritoneal seeding during surgical resection of the tumor. Seeding occurs when a tumor is
excised and cancer breaks off from the tumor into the peritoneal cavity. Although colorectal cancer can
strike at any age, more than 9 in 10 new cases are in people aged 50 or older. Jews of Eastern European
descent (Ashkenazi Jews) may have a higher rate of colon cancer. Because of disproportionate screening,
minorities, particularly African-Americans and Hispanics, are more likely to be diagnosed with colorectal
cancer in advanced stages. As a result, death rates ate higher for these populations. A personal history of
colon cancer or intestinal polyps, and diseases such as chronic ulcerative colitis, Crohns disease and
inflammatory bowel disease increase a persons risk of developing colorectal cancer. Individuals with a first-
degree relative (sister, sibling, or child) diagnosed with colorectal cancer have a threefold to fourfold risk of
developing the disease. There are two autosomal dominant inherited genetic disorders known as familial
adenomatous polyposis (FAP) which accounts for 1% or CRCs, and hereditary nonpolyposis colorectal
cancer (HNPCC) which accounts for 10% of all colorectal cancers. A diet made up mostly of foods that are
high in fate, especially from animal sources, can increase the risk of colorectal cancer. People who are not
active have a higher risk of colorectal cancer. Recent studies show that smokers are 30% to 40% more likely
than nonsmokers to die of colorectal cancer. Heavy use of alcohol has been linked to colorectal cancer.
Signs and symptoms include: a change in bowel habits, diarrhea or constipation, feeling that the bowel does
not empty completely, vomiting, blood in the stool, abdominal discomfort (gas, bloating, cramps), weight loss
for no known reasons, constant tiredness, unexplained anemia. Diagnostic screening includes: Fecal Occult
Blood Test, Flexible Sigmoidoscopy, Double Contrast Barium Enema, and Colonoscopy.

Colon Cancer Alliance, http://www.ccalliance.org

Medical-Surgical Nursing 5 th Edition, Ignatavicius, Workman

List and prioritize any secondary diagnosis that has been identified for your client (Based on your patient's
problems).

1. Hyperlipidemia
2. Hypertension
3. Diabetes Mellitus (Type 2)

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