Clinical Manifestations

1.     Using a problem solving (Specific, Measurable, Achievable, Realistic, Time Specific) SMART approach, achievable goals and evidence based practice, provide a written report addressing the following:   a.     Identify the clinical manifestations of the chronic health problem and possible impact on body systems. Bowel cancer can affect the body system in many ways, it causes disruption in the absorption of water and nutrition by preventing stool from passing through. This can cause pain the abdomen, bloating, weight loss and discomfort of digesting food. The haemoglobin levels may be low if blood is passed through the stools, this will be revealed in blood tests. In the later staged on bowel cancer, the cancer can spread into other organs such as the bones or lungs.     b.     Confirm and summarize your understanding of their chronic condition.   Bowel cancer can affect the large bowels, this usually occurs in older people in their 50s and older. It’s not common for younger people to get it. It is also known as colorectal cancer, it starts as a small polyp, which is harmless but can become cancerous over time. It is important to get regular test when 50 years and over, if its un-non and not treated the cancer can grow into the deeper layers of the bowel wall. Is can cause many discomfort   c.      Describe the pathophysiological processes associated with the chronic illness. If possible, support your written response with diagrams and/or photographs.     d.     Identify three specific nursing interventions that are relevant for the person and their chronic health problem how the intervention may be implemented, why the intervention may be implemented and expected outcomes related to the intervention.   A nursing intervention that the nurse should have the knowledge of bowel cancer and she should be able to educate the patient about how to take care and self-manage their cancer. It is relevant for the patient to have a good diet and know what they should and shouldn’t eat. It’s important that they don’t consume a high intake of meats and fat, these will increase the risk of bowel cancer. It is highly recommended that they live a healthy lifestyle and the patient should be informed of the risk factors that may increase the chance or worsens bowel cancer. Risk factors can be smoking, not having adequate exercise, alcohol consumption will increase bowel cancer. There is a kit that it sent to those who have turned 50 called faecal occult blood test (FOBT). These are for individual that are at a low risk and do not have a family history of Bowel cancer. Another nursing intervention is it to encourage the patients to receive treatment and regular check ups just as radiotherapy and chemotherapy   e.     Discuss the potential social, emotional and psychological symptoms that impact on the person’s ability to achieve maximum performance in ADLs. You may also need to consider the impact on the person / family / significant others. The impacts of having bowel cancer may be very difficult for the patient, as well as family, friends and caregivers. The psychological impact that they may experience are anxiety, depression and destress. This is an extremely challenging event in their life and if the patient doesn’t have the support and encouragement from others then this could really be tough on them. It is crucial that they know the support services that are out there for them to rely on. In terms of having bowel cancer the patient will have symptoms of tiredness, weight loss, and weakness, so socialising would be very tough since they won’t have enough energy to participate in many social events. The patient will be unable to contribute much in ADL’s and heavy exercises for long. Emotionally the patient would feel sad, helpless when they are not to help out with the family if they were the money maker in the household, feeling financially burdened because of the cancer treatment.   f.      Write a Nursing Care Plan for the person using the nursing process. A Nursing Care Plan template has been provided. This Care Plan should include nursing diagnosis of identified problems, and evaluation of the possible nursing interventions for the person.   g.     Conduct an academic search of literature and identify current best practice associated with one nursing intervention for the person’s chronic health problem.   h.     Describe three strategies that could actively involve the person to self-manage their chronic disease.   Strategies that can be implemented to self-manage patients own chronic illness is to have a good and healthy diet. Self-managing one’s own diet can improve their strength and slow the process of the cancer spreading. Encouraging them to live a healthy life and have regular checkups medication.     i.       Identify other supporting agencies / health professionals that could contribute to the care of the person’s individual needs. Dietitians, Genetic councillor Social workers Physiotherapist, Occupational therapist Phycologist Cancer care co-ordinators Colorectal surgeons Radiational oncologist Gastroenterologist   j.       List three resources and support services which could be accessed by the person and their significant other(s) on discharge.

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