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Tumors of the colon and rectum are common and are the third most common of new cancer cases in the United States. (Hinkle & Cheever, 2014). The lifetime risk for developing this type of cancer is 1 in 20, making it the third leading cause of cancer death in men and women in the United States as well. (Hinkle & Cheever, 2014). With early diagnosis and treatment available for improved screening, deaths from colorectal cancer has decreased. (Hinkle & Cheever, 2014). The main treatment for this type of cancer is surgery using techniques of re-sectioning sections of the bowel, thereby requiring a colostomy for drainage of bowel contents. (Hinkle & Cheever, 2014). Chemotherapy and radiation therapy can be used before or after surgery as an adjuvant therapy usually resulting in increased survival time and less instances of tumor recurrence. (Hinkle & Cheever, 2014). Many improvements exist that help reduces deaths from colon cancer. Prevention and screening are the keys to reducing the mortality rate. Patient B of the discussion is a survivor of colon cancer treated with surgical, radiation, and chemotherapy methods. The National Cancer Institute states that an individual is a cancer survivor from the time of diagnosis throughout the balance of their life. (Weaver, Jessup, & Mayer, 2013). Families, friends, and caregivers that are impacted are considered to be survivors as well. (Weaver, Jessup, & Mayer, 2013). Cancer survivorship should respond to the patients’ psychosocial, physical, and economic issues. (Weaver, Jessup, & Mayer, 2013). Nurses help to develop survivorship care plans, provide education, and care for cancer survivors. (Hinkle & Cheever, 2014).There are many applicable nursing diagnoses and interventions that would be applicable to this patient and her care. One intervention I believe the nurse will need to implement for Patient B is to ensure the patient will maintain optimal nutrition throughout her admission. Malnutrition is a late and long-term effect of radiation, chemo, and surgery. This intervention would focus mostly on educating the patient on the benefits of a healthy diet and helping to individualize a nutritional plan that does not cause problems with bowel function. “The period after active treatment is often considered a ‘teachable moment’ and is an opportune time to promote healthy lifestyle behaviors” (Weaver, Jessup, & Mayer, 2013). First we would want to complete a nutritional assessment (Hinkle & Cheever, 2014). Counseling the patient on foods to avoid that may cause excessive odors and gas such as cabbage, eggs, fish, beans, and/or peanuts; advising to experiment with potentially irritating foods before excluding it due to initial sensitivity; and identifying foods that may be causing diarrhea would be part of the patient education. (Hinkle & Cheever, 2014). Encouragement should be provided to increase fluids and use a laxative for constipation as needed. If necessary, the nurse can assist in requesting pharmacological treatment for diarrhea as needed. Dietician referrals may be required to ensure the patient is receiving what he needs along with the treatments that she is receiving so that she maintains a healthy body weight.One of the most common commodities of colon cancer is cardiovascular disease. (Weaver, Jessup, & Mayer, 2013). For this reason, another intervention I would focus on is helping to develop an exercise/physical activity plan for this patient. The American Cancer Society recommends physical activity for overall health, well-being, and prevention of comorbid conditions. The exercise plan should be individualized to the patient with considerations made for fitness level prior to care and the level of treatment they are currently receiving that may cause limited restrictions to physical activity. A good guideline would be to encourage 150 minutes of moderate level activity weekly. The nurse can assist in figuring out safe exercise activities based on activity tolerance and make referrals to physical therapy for assistance as needed. The inter-professional team for this patient would require a lot of cooperation between providers to provide the best overall cancer survivorship care. One critical member of this team would be the primary care provider. Cancer survivorship typically begins in the primary care office when the patient is told of their diagnosis and informed that further testing is needed. (Weaver, Jessup, & Mayer, 2013). Quality of care increases when the oncologist and primary care provider communicate effectively. (Weaver, Jessup, & Mayer, 2013). The primary care provider continues to provide preventative care such as flu/pneumonia vaccination, counseling for healthy lifestyle behaviors, and screenings for any other chronic diseases or comorbidities.

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