E. B., age 49 years, is a teacher who has been treated for colon cancer that was detected by
colonoscopy. Yesterday he had a partial colectomy with a formation of a temporary
colostomy. The dressing over the abdominal incision has a 3 cm area of bloody drainage on
it. The colostomy is draining brown, liquid stool. Bowel sounds are absent. He has a
nasogastric tube inserted through the right nares that is attached to low intermittent
suction and is draining reddish-brown fluid. His IV is infusing through a right peripherally
inserted central catheter with D5NS at 75 mL/hour, and he is receiving two IV antibiotics.
He is NPO but asking for ice chips.
- Discuss the developmental, age, socioeconomic, and cross-cultural considerations that
should be considered during the gathering of subjective and objective data and the
provision of health care when reassessing the hospitalized patient.
- Relate expected (normal) findings to the findings described,
- discuss any additional information that might be needed before a judgment or diagnosis
can be made
- Identify at least one relevant nursing diagnosis for any actual or potential problem
COLON CANCER CASE STUDY
Recently, colon cancer has become the third most highly diagnosed cancer among men
and women in hospitals globally and second place in cancer-related deaths. Risk factors such as
age, family history and genes, personal history, and life factors like excessive alcohol intake,
physical inactivity, obesity, and smoking increase chances of individuals developing colon
cancer (Mandelblatt, Yabroff & Kerner, 2009). Colon cancer affects the colon whereby there are
genetic changes in colon normal cells leading to growth of abnormal cells resulting in adenomas
which progress to colon or colorectal cancer. Considerations in development, age,
socioeconomic, cross-cultural factors are necessary in prevention, detection, and treatment of
colorectal cancer in patients to ensure effective health care provision (Mandelblatt, Yabroff &
CASE STUDY 2
Developmental factors enable determine the extent to which cancer spread in the colon or
the body efficiently. Development in terms of technological advancement and expertise of a
hospital determines if the correct treatment and prognosis is applied. The stages of colon cancer
that is localized, regional, distant, and unstaged require updated colorectal cancer screening tests.
Age of physicians as well as patients has diverse effects on health care provision and
recovery of patients. In most cases, elderly physicians are slower in adapting to changes in
technological advancement in current cancer treatment. Age of patient also determines their level
of awareness in colon cancer treatment and guidelines. It also impacts on their understanding of
the necessary after surgery guidelines in health care (Mandelblatt, Yabroff & Kerner, 2009).
Socioeconomic factors like family support, financial support, community awareness
among others also affects health outcomes after colon cancer surgery. Colectomy surgical
procedure is major and requires stable finances and loving and caring family members to ensure
good prognosis leading to normal life for patients.
Cross-cultural encounters are inevitable in surgical or medical practice whereby cultural
diversity positively or negatively affects health outcome of patients. Factors like ethnicity, skin
color, religion, geographical origin, gender, sexual orientation, and marital status among others
impact on doctor-patient interaction (Mandelblatt, Yabroff & Kerner, 2009). Physicians should
embrace all diverse cultural practices through cultural literacy to promote cultural competence
hence ensuring better health outcomes.
CASE STUDY 3
Mandelblatt, J., Yabroff, K., & Kerner, J. (2009). Access to Quality Cancer Care: Evaluating
and Ensuring Equitable Services, Quality of Life, and Survival. Institute of Medicine