Question: Diagnosis/Surgery: Harold Is A 54 Year Old Male With Complaints Of Constipation, Abdominal Cramping And Ribbon-like Stools X 2 Months. His Primary Care Physician Referred Him To A Gastro-enterologist Who Ordered A Colonoscopy. Biopsies Were Taken During The Colonoscopy Which Showed A 8 Cm Tumor In The Descending Colon, With 4/10 Lymph Nodes Positive …

Diagnosis/Surgery: Harold is a 54 year old male with complaints of constipation, abdominal cramping and ribbon-like stools x 2 months. His primary care physician referred him to a gastro-enterologist who ordered a colonoscopy. Biopsies were taken during the colonoscopy which showed a 8 cm tumor in the descending colon, with 4/10 lymph nodes positive for malignancy. The pathology report showed an adenocarcinoma of the colon. A CT scan was performed which showed multiple areas of metastasis in the liver and lungs. Harold is scheduled for a partial colectomy to remove the tumor and insertion of a port-a cath for chemotherapy. He may have a temporary colostomy. You are doing his pre-operative teaching Nursing Management- Admission: Harold recovered well from the surgery and his temporary colostomy has been reversed. He received his first chemotherapy treatment with IV 5flourouracil and Oxaliplatin 10 days ago, and is admitted to your unit again with a diagnosis of ro sepsis. He is in a semi- private room with a post-op patient that has C diff. His CBC is as follows: WBC. 600/mm3 Hgt: 6.2 g/dL Hct: 24% Platelets: 22.000/mm3 What is your priority nursing diagnosis? 2 What are your priority interventions at this time, based on the above clinical data? Explain why you chose these as priority for this particular patient. List 2 appropriate outcomes for this patient How would you evaluate these outcomes? s Discuss the implications of a neutropenic dehydrated, mainourished patient having diarrhea. What effect might this have on his skin integrity? What complications would you monitor for? What nursing interventions would you incorporate into the plan of care to address this? Would you suggest any collaborative interventions? 3. List 2 appropriate outcomes for this patient. How would you evaluate these outcomes? 5. Discuss the implications of a neutropenic, dehydrated, malnourished patient having diarrhea. What effect might this have on his skin integrity? What complications would you monitor for? What nursing interventions would you incorporate into the plan of care to address this? Would you suggest any collaborative interventions? The nursing assistant has just informed you that Harold is cold and sweaty and he is shaking in the bed. 6. What is your priority now? 7. Can you delegate anything to the nursing assistant? What are possible complications of an infection in this client? Why is this client at high risk for infection? 10. How do the results of the blood cultures guide treatment for this patient?