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    CA Colorectal

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    Raudhiatul Azzahra
    The document discusses colorectal cancer, including its definition, etiology, signs and symptoms, stages, and management. It provides details on: - Colorectal cancer occurs in the colon, rectum, and appendix and is typically found through colonoscopy and treated with surgery and chemotherapy. - Risk factors include diet, reduced bowel movement time, and consuming red meat and processed foods while protective factors include fruits, vegetables, and whole grains. - Signs and symptoms vary but can include changes in bowel habits, blood in stool, weight loss, fatigue, and the formation of tumors. It spreads via direct contact or through the lymph or blood systems. - Staging involves assessing if the cancer is localized or

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    CA Colorectal

    Uploaded by

    Raudhiatul Azzahra
    67 views19 pages
    The document discusses colorectal cancer, including its definition, etiology, signs and symptoms, stages, and management. It provides details on: - Colorectal cancer occurs in the colon, rectum, and appendix and is typically found through colonoscopy and treated with surgery and chemotherapy. - Risk factors include diet, reduced bowel movement time, and consuming red meat and processed foods while protective factors include fruits, vegetables, and whole grains. - Signs and symptoms vary but can include changes in bowel habits, blood in stool, weight loss, fatigue, and the formation of tumors. It spreads via direct contact or through the lymph or blood systems. - Staging involves assessing if the cancer is localized or

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    The document discusses colorectal cancer, including its definition, etiology, signs and symptoms, stages, and management. It provides details on: - Colorectal cancer occurs in the colon, rectum, and appendix and is typically found through colonoscopy and treated with surgery and chemotherapy. - Risk factors include diet, reduced bowel movement time, and consuming red meat and processed foods while protective factors include fruits, vegetables, and whole grains. - Signs and symptoms vary but can include changes in bowel habits, blood in stool, weight loss, fatigue, and the formation of tumors. It spreads via direct contact or through the lymph or blood systems. - Staging involves assessing if the cancer is localized or

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    67 views19 pages

    CA Colorectal

    Uploaded by

    Raudhiatul Azzahra
    The document discusses colorectal cancer, including its definition, etiology, signs and symptoms, stages, and management. It provides details on: - Colorectal cancer occurs in the colon, rectum, and appendix and is typically found through colonoscopy and treated with surgery and chemotherapy. - Risk factors include diet, reduced bowel movement time, and consuming red meat and processed foods while protective factors include fruits, vegetables, and whole grains. - Signs and symptoms vary but can include changes in bowel habits, blood in stool, weight loss, fatigue, and the formation of tumors. It spreads via direct contact or through the lymph or blood systems. - Staging involves assessing if the cancer is localized or

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    Ca

    COLORECTAL
    Group 2
    Sri Inda Rahayu 21117113
    Susanti 21117115
    Syarah Huda 21117117
    Tia Novelia 21117119
    Tias Rido Perdana 21117121
    Tinti 21117123
    Tuti Dwi Sofiyanti 21117125
    DEFENITION

     Colorectal Cancer otherwise known as


    Ca. Colon or Colon Cancer is a form of
    malignancy that occurs in the colon,
    rectum, and appendix (appendix).
     To find it is needed an action which is
    called a colonoscopy, while the
    treatment is through surgery followed by
    chemotherapy.
    ETIOLOGY

     The cause of Colon cancer is unknown. Diet and reduction


    in circulation time in the large intestine (front flow of stool)
    which includes causative factors. Foods to avoid:
     Red meat
     Animal fat
     Fatty foods
     Fried or grilled meat and fish
     Filtered carbohydrates (example: filtered juice)
     Food to be consumed:
     Fruits and vegetables especially Craciferous Vegetables
    from cabbage groups (such as broccoli, brussels sprouts)
     Whole grain of rice
     Adequate liquid, especially water
    Signs and sympthoms
    The local symptoms are:
     Changes in bowel habits
     Changes in frequency of urination, decrease (constipation) or increase (diarrhea)
     Sensation such as not finished urinating, (still wants but can't get out) and changes in the
    diameter and size of the stool (feces). Both are characteristic of colorectal cancer
     Changes in physical form of feces / feces
     Stool mixed with blood or bleeding from the drain hole when defecating
     Mucous faeces are blackish in color, usually associated with bleeding in the upper
    digestive tract
     Pain arises accompanied by nausea and vomiting during bowel movements, resulting from
    obstruction of the sewage tract by the tumor mass
     There is a lump in the stomach that may be felt by the sufferer
     Other symptoms arise around the location of the tumor, because
    cancer can grow about the organs and tissues surrounding the
    tumor, such as the bladder (blood arises in urine, air bubbles arise,
    etc.), the vagina (smelling vaginal discharge, excessive mucus
    appears, etc). These symptoms occur later, showing the greater the
    tumor and the wider the spread. The general symptoms are:
     Weight loss without obvious cause (this is the most common symptom in all types of
    malignancy)
     Loss of appetite
     Anemia, the patient appears pale
     Often feeling tired
    Signs and sympthoms
    Symptoms of the spread are:
    Spread to the liver, causing symptoms:
    a. The patient appears yellow
    b. Abdominal pain, more often in the upper right, around the location of the
    liver
    c. Enlarged liver, usually seen on a physical examination by a doctor
    d. Another symptom called paraneoplastik arises, associated with increased
    blood viscosity due to the spread of cancer.
    Levels / Staging / Stadium of Colon Cancer There are several types
    of staging classifications of colon cancer, there is a classification of TNM,
    Dukes classification, but what I will describe is the following classification
    (similar to the Dukes classification):
    a. Stage 1: Cancer occurs inside the colon wall
    b. Stage 2: Cancer has spread to the muscle layer of the colon
    c. Stage 3: Cancer has spread to the lymph glands
    d. Stage 4: Cancer has spread to other organs.
    CLINICAL MANIFESTATIONS

     Symptoms are largely determined by the


    location of the cancer, the stage of the
    disease, and the function of the intestinal
    segment where the cancer is located. The
    most prominent symptom is a change in
    habit of defecation.
     . Symptoms can also be anemia of unknown
    cause, anorexia, or weight loss and fatigue.
    Anatomical physiology
    Anatomi :
    1. Intestine crassum
    large intestine
    2. Appendix
    vermiformis
    3. Colon transversum
    4. Colon descendens
    5. Colon sigmoideu

    Physiology:
    The main function of
    the colom is the
    afsorvetion obwater
    and electrolytest from
    kimus to fom denche
    feces and
    accumulation of
    faecal material until it
    cenbi removed
    (guyton,2008).
    PATHOPYSIOLOG
    Tumors can spread through:
     Direct infiltration into adjacent structures, such as into the bladder
    (urinary vesica).
     Spread through lymphogenic lymph vessels to pericolone lymph
    glands and mesocolones.
     Through blood flow, hematogenous is usually to the liver because
    the colon drains blood back to the portal system.
    Stadium in colon cancer patients according to Syamsu
    Hidyat
    (1197) including:
    1. Stage I if the presence of cancer cells is still limited to the lining
    of the large intestine (mucous layer).
    2. Stage II occurs when cancer cells have entered the muscle
    tissue under the mucous layer.
    3. In stage III cancer cells have spread to a portion of the lymph
    nodes that are mostly found around the intestine.
    4. Stage IV occurs when cancer cells have attacked the entire
    lymph gland or even to other organs
    Pathway
    COMPLICATIONS
     Tumor growth can cause partial or complete
    intestinal obstruction.
     Metastases to surrounding organs, through
    hematogens, lymphogens and direct spread.
     Growth and ulceration can also attack blood
    vessels around the colon which cause
    hemorrhage.
     Intestinal perforation can occur and result in
    abscess formation.
     Peritonitis and or sepsis can cause shock.
     Abscess formation Formation of the fistula in the
    urinary bladder or vagina.
    MANAGEMENT
     Medical management Patients with symptoms of intestinal obstruction are
    treated with IV fluid and nasogastric suction. If there is bleeding that is
    significant enough therapeutic components of blood can be given.
     Surgical management Surgery is the primary action for most colon and
    rectal cancers, surgery can be curative or palliative.
     The type of surgery depends on the location and size of the tumor.
    Selected surgical procedures are as follows.

    1. Segmental resection with anastomosis (removal of the tumor and portion of


    the intestine on the growth side, blood vessels and lymphatic nodes)
    2. Abominoperineal resection with permanent sigmoid colostomy (removal of
    the tumor and sigmoid portion and all the rectum and anal sphincter)
    3.Temporary colostomy is followed by segmental resection and anastomosis
    and further reanastomosis of the colostomy
    4. Permanent colostomy or iliostomy (to cure unresectable obstruction
    lesions).
    NURSING MANAGEMENT

    1. Support adaptation and independence.


    2. Increase comfort.
    3. Maintain optimal physiological functions.
    4. Prevent complications.
    5. Provides information about process /
    disease conditions, prognosis, and
    treatment needs.
    EXAMINATION OF SUPPORTERS

    1. Endoscopy.
    2. Radiology
    3. Ultrasonography (USG
    4. Histopathology
    5. Laboratory
    6. Scan
    7. Biopsy
    8. Complete blood count with differential and
    platelet: Can show anemia, changes in red blood
    cells and white blood cells: platelets increase or
    decrease.
    9. Chest X-ray
    CLASSIFICATION and TYPE

    Tumors in the colon and rectum (colorectal) or


    large intestine are of two kinds,
    Benign tumors are divided into:
    1. Epithelial tumors, consisting of: Adenoma and
    Adenomatosis
    2. Nonepithelial tumors, consisting of: Leomioma,
    Hemangioma, and Lipoma

    Malignant tumors consist of:


    1. Carcinoma
    2. Sarcoma
    NURSING DIAGNOSIS

     Nursing diagnoses based on data analysis according


    to Marilynn E. Doenges (1999), Brunner and Suddarth
    (2001), and Lynda Selll Carpenito (1997).
    1. Anxiety / fear is related to crisis situations (cancer)
    2. Pain (acute) associated with tissue trauma and
    muscle spasm reflex secondary to colon cancer.
    3. Changes in nutrition less than the body's needs are
    related to hypometabolic status with regard to cancer.
    4. High risk of lack of fluid volume is associated with less
    fluid input
    5. Fatigue is related to changes in body chemistry: side
    effects of drugs, chemotherapy.
    NURSING INTERVENTION
    1. Anxiety / fear is related to crisis situations (cancer)
    Objective: After nursing actions anxiety can be reduced or can be controlled.
    Intervention:
    a. Encourage patients to express thoughts and feelings.
    b. Provide an open environment where patients feel safe.
    c. Maintain frequent contact with patients.
    d. Help the patient / person closest to recognizing fear
    e. Improve calm and calm environment

    2. Pain (acute) is associated with discontinuation of continuity of skin tissue


    secondary to surgical procedures.
    Objective: After nursing action is expected the patient can report maximum
    pain relief / control with minimal influence.
    Intervention:
    a. Determine the history of pain, such as the location of pain,
    frequency, duration, and intensity, and the remedial actions performed.
    b. Give basic comfort actions and entertainment activities.
    NURSING INTERVENTION
    c. Encourage pain management skills such as deep breathing
    relaxation techniques (by pulling the breath through the nose hold up to a
    count of ten, then exhale softly through the mouth while feeling),
    laughing, music, and therapeutic touches.
    d. Pain relief / control evaluation.

    4. Changes in nutrition less than the body's needs are related to


    hypermetabolic status with regard to cancer.
    Objective: After nursing action is expected the patient can demonstrate a
    stable body weight.
    Intervention:
    a. Monitor input every day.
    b. Weigh your weight every day or as indicated.
    c. Encourage patients to eat high-calorie and nutrient-rich diets
    with adequate fluid input.
    d. Encourage patients to eat small but frequent meals.
    e. Create a pleasant dining atmosphere.
    f. Identify patients who have anticipated nausea / vomiting.
    CONCLUSION

     Colon cancer is a cancer that is in the


    colon. Colon cancer is the second
    leading cause of death in the United
    States after lung cancer (ACS 1998) This
    disease is a deadly disease because the
    disease is often not known to a more
    severe extent. Surgery is the only way to
    change Colon cancer.
    Thank you

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