M.W. is a 70-year-old white woman with a medical history of hypertension, osteoarthritis, atrial fibrillation, and total hysterectomy who lives by herself in a two-story row home. She visits the….
Describe the pathogenesis of Brian’s colorectal cancer from the initial cellular mutation to the diagnosis of stage IIA colorectal cancer
Assessment 2 : Short Answer Test (SAT)/ In class closed book assessment based on the case study of Brian Jones.
Word count: 1000 words
Content that exceeds the word limit plus 10% will not be marked and consequently will not attract marks
Due Date: Week 5, in registered tutorials
This is a closed book assessment that will be completed in your tutorial class in week 5.
All students must attend their allocated tutorial to complete this assessment.
You have an allocated time of 90 minutes
Marking Criteria and Standards: See page 11 of this Learning Guide.
Aim of assessment
The purpose of this short answer test in class assessment is to enable the student to demonstrate:
– An understanding of the principles of perioperative nursing care (Learning outcome 1).
– An understanding of the role of the nurse in the perioperative period (Learning outcome 2).
– An understanding of the relationships between pathophysiology and cancer control initiatives (Learning outcome 5)
– How safe and effective administration of pharmacological agents support people in perioperative care (Learning outcome 1, 6 & 7).
– An evaluation of relevant literature to support an understanding of the pathophysiology, pharmacological and nursing management of a person experiencing the effects of bowel cancer and is able to express this in a clear and succinct writing style (Learning outcome 9).
Brian Jones (aged 50) presented to his GP with a nine month (9/12) history of a change in his bowel habits, abdominal pain and fatigue. His GP ordered Faecal Occult Blood testing which confirmed the presence of blood in Brian’s stool. Following this, Brian’s GP referred him to a gastrointestinal specialist. The specialist recommended Brian have a colonoscopy. During the colonoscopy, a biopsy was taken of a lesion located in Brian’s rectum. The biopsy results confirmed a Stage IIA rectal carcinoma. Brian was admitted to hospital for an abdomino-perineal resection and the formation of a colostomy.
Brian returned to the surgical ward postoperatively. On his return, Brian has
a patient controlled analgesia (PCA) infusion of 50mgs of Morphine in 50ml NaCl running at 4mL/hr,
0.9% NaCl (Sodium Chloride) IVI running at 125mL/hr via an IVC in his left arm,
a sigmoid colostomy with a small amount of haemoserous fluid evident,
2 x Haemovac drains in situ on suction with 100mls frank blood in total,
a nasogastric (NG) tube in situ on free drainage with 4/24 aspirations,
an indwelling urinary catheter (IDC) with 50mls of urine output,
regular medications ordered
metronidazole (Flagyl) IVI 500mgs in 100mLs 8/24
paracetamol (Panadol) 1g IVI 6/24,
enoxaparin (Clexane) 40mgs sub cutanously daily, and
metoclopramide (Maxalon) 10mgs 8/24 PRN.
401010 – Health Variations 1 Learning Guide – Autumn 2015
©School of Nursing and Midwifery Page 10 of 23 University of Western Sydney
Question 1 -10 marks (300 words)
Describe the pathogenesis of Brian’s colorectal cancer from the initial cellular mutation to the diagnosis of stage IIA colorectal cancer (Learning outcome 5).
Question 2 – 10 marks (300 words)
Describe two (2) modifiable and three (3) non-modifiable risk factors for colorectal cancer and explain how these risk factors may have contributed to the development of Brian’s colorectal cancer (Learning outcome 5).
Question 3 – 5 marks (150 words)
- a) Describe the action and mechanism of action of metronidazole (Flagyl) in relation to its administration to Brian.
- b) Describe the action and mechanism of action of Morphine in relation to its administration to Brian. (Learning outcomes 6 & 7).
Question 4 – 10 marks (250 words)
Discuss the nursing responsibilities with associated rationales in relation to administering Morphine to Brian. (Learning outcomes 2, 6 & 7).
- There are a number of textbooks and resources available through the UWS Library that may assist you. Please refer to the unit’s vUWS site for specific unit resources