Adenocarcinoma of the rectum arises as an intramucosal epithelial lesion, usually in an adenomatous polyp or gland. As cancers grow, they invade the muscularis mucosa, lymphatic structures, and vascular structures and involve regional lymph nodes, adjacent structures, and distant sites, especially the liver.

Nursing goal for a patient with Rectal CA can be towards managing pain, managing symptoms, and patient education.

Acute Pain

The patient has colorectal cancer and one of its symptoms is abdominal pain. The pain is a subjective unpleasant sensation resulting from stimulation of sensory nerve endings by injury, or other harmful factors. Pain is activated when a pt’s pain threshold is reached. Pain threshold is the point at which a stimulus activates pain receptors to produce a feeling of pain. Pain usually accompanies inflammation. It results from the synthesis of prostaglandins, which are hormones produced during the inflammatory process.

Constipation

Due to decrease physical activity of patient, the movement of feces through the large intestine is slow, thus, the patient manifest difficulty or decreased frequency in defecation. And also there is a presence of blockage in the intestines forming bulk and therefore the stool cannot pass through. (Ed notes: also there is painful and straining-like passage of stool)

Impaired Bed Mobility

Abdominal cramping because of colorectal cancer there is a blockage of stool and formation of masse It starts from the synthesis of prostaglandins, which are hormones produced during the inflammatory process. The pain is triggered when the patient is moving so the response of the patient  he/she will not move to prevent initiation of pain.

Activity Intolerance

Activity intolerance is brought about by the weakness. Weakness is caused by cancer, cancer cells get the nutrients that normal cell needs. In this situation normal cell lack nutrients so they cannot perform their functions. There will energy that the body can use so instead of doing daily activities the patient will just take rest.

Self-Care Deficit

Restriction on the physical mobility of the client has resulted to a decreased ability for selfcare.  Specifically for this client, he has been unable to perform activities like bathing (and other measures of grooming), dressing up and attend to toileting needs by herself, thus, there is selfcare deficit. Weakness that is brought by cancer normal cells are lacking in nutrients. That the body needs in order to perform activities of daily living.

Knowledge Deficit

They cannot understand diagnostic procedures that’s why doctors and nurses must explain medical procedures to the patient level of understanding. And also they lack knowledge about the surgery. The affected colon must be remove as what the doctor decides.

Risk for Impaired Skin Integrity

Prolonged physical immobilization may cause pressure ulcers. Pressure ulcers may be caused by inadequate blood supply and as a result of  reperfusion injury when blood reenters tissue. A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time: the dull ache experienced is indicative of impeded blood flow to affected areas

Conclusion

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Source:

• eMedicine: Rectal Adenocarcinoma

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