associated with right sided lesions dull abdominal pain melena black tarry

associated with right-sided lesions  dull abdominal pain  melena (black, tarry stools) associated with left-sided lesions (obstruction)  abdominal pain  cramping  narrowing stools  constipation  distention

 bright red blood in the stool. Symptoms associated with rectal lesions  tenesmus (feeling of incomplete defecation)  rectal pain  alternating constipation and diarrhea  bloody stool Diagnosis: SCREENING is important (colonoscopy) Adults should start to get screened at 50 years old Complications: Tumor growth may cause partial or complete bowel obstruction or perforation. Treatment : Depends on the stage of the disease and consists of surgery to remove the tumor, supportive therapy, and adjuvant therapy Surgery is the mainstay of treatment for colorectal cancer. It may be curative or palliative. Surgical management: Page 1346

12. Ostomies *Ostomy care/Nursing Interventions (Table 47-7 and 47-8) 1. Sigmoid (Solid/formed feces) 2. Descending (Semi-formed) 3. Transverse (Formless) 4. Ascending (Semi-liquid) 5. Cecostomy (Semi-fluid/Fluid) 6. Ileostomy (Semi-fluid/Fluid)

13. Total Parenteral Nutrition  Requires central line with PUMP  Provide needed calories, spares body proteins from catabolism for energy requirements Complications  Fluid Imbalance- TPN hyperosmolar stimulates fluid shifts. Esp. watch those with CRI or CHF  Electrolyte Imbalances- may need to alter contents of TPN. Monitor serum and electrolyte values frequently  Hyperglycemia- frequent blood glucose checks (Listen to lecture to fill in)  Keep refrigerated  Central line needed  Filter needed  Dedicated line  Discontinue gradually to avoid _______________  May have to start taking __________  Recipe changes daily  Change tubing with each new bag  ALWAYS on a pump!  Most frequent complication is _______