MT, a 58 y.o., woman was diagnosed with colon cancer 3 years. Previous medical history in relation to this includes colon resection followed by 6 cycles of combined chemotherapy completed around 18 months ago. History also revealed that she has smoked for 50 pack years (2 packs/day in 25 years). Current diagnosis of MT is recurrent colon cancer. She has already completed 5 out of the scheduled 8 chemotherapy cycles. He has shown significant weight loss (height: 5’3″ with current weight of 98lbs.). Her current admission was for proper management of dehydration. She is found to be nutritionally depleted. The surgeon noted that they need to do an exploratory laparotomy for lysis of adhesions, small bowel resection, colectomy, and colostomy with Hartman’s pouch. Surgery was performed and MT is transferred to Surgical ICU where you are on duty. She has a large abdominal dressing and she was ordered to be placed on total parenteral nutrition (TPN). When you rolled MT side to side to remove the soiled surgical linen, the dressing became saturated with large amount of serosanguineous drainage.
- What are the risk factors for Colon Cancer?
- Since colon cancer may be hereditary, what would you teach the family of the above client about colon cancer prevention?
- What are the goals of surgery in this case as a cancer treatment modality?
- Traditionally, the surgeon performs the first dressing change, why is this done?
- Given your observation of the dressing, what will be your actions?
- When and why is TPN indicated for patients?