Case Study Of Rectal Cancer

Decent Essays
Beginning of shift: FULL CODE -The patient is a 70 -year- old male with stage IV rectal cancer, currently being treated with chemotherapy for the past 6 months. The patient came to the ER with a 3 -day history of worsening abdominal pain. The patient’s weight is 116 pounds and the is height 5 feet and 7 inches. The patient states pain on a scale from 0 to 10 at a 4. The patient has no fever but states that he is cold. No sore throat. No chest pain or palpitations are reported. There is no nausea or vomiting but the patient is constipated. The skin has no rashes or lesions. The patient is alert and oriented times 3 (person, time and place). The patient is hypotensive with the following vitals: blood pressure is 92/76 mmHg, respirations is…show more content…
2 liters nasal cannula (97% room air) The patient has never smoke, drank alcohol or use drugs. The valve bag mask and the yankauer are available. TRANSITION:
There were two options available for the patient in this medical emergency: doing surgery or not doing surgery to solve the perforated rectum.
Surgery decision: The family was having a hard time deciding to have surgery perform or not some family members did not want the patient to have surgery. The wife, and the patient agreed to have surgery perform after speaking with the doctors. The doctors using an interpreter explained to the patient and his wife that the surgery was very risky and could maybe not survive surgery due to the overall deteriorating health of the patient. It took time for the patient to go to the OR because the wife wanted her daughters to come to the hospital to see their father before the surgery. The consent forms were signed, and the patient was in the OR a good part of the day.
End of the shift: The patient came back toward the end of my shift. When the patient came back from the OR, he was intubated. The NG tube, the porta catheter for chemo therapy and IV line were still on. He had an arterial line, a colostomy bag, a Foley catheter and sequential compression devices. His vital signs were blood pressure 86/ 70 mmHg, respirations were 20 breaths per minute, heart rate 110 bmp, and temperature 97.8 F. The nurse gave 2 units of
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