Colon Cancer- module 1 114

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which of the following abnormalities associated with this oncologic emergency?" a. hypokalemia b. hypocalcemia c. hypouricemia d. hypophosphatemia"

"Answer b: TLS is a metabolic complication characterized by rapid release ofintracellular components in response to chemotherapy. This can rapidly lead to acute renal failure. The hallmark signs of TLS are hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia."

The nurse is teaching a client about the modifiable risk factors than can reduce the risk for colorectal cancer. The nurse places the highest priority on discussing which risk factor with this client?" A. Age older than 30 years B. High fat and low fiber diet C. Distant relative with colorectal cancer D. Personal history of ulcerative colitis or GI polyps"

"Correct Answer: BRationale: Common risk factors for colorectal cancer that cannot be changed include age older than 40, first-degree relative with colorectal caner, and history of bowel problems such as ulcerative colitis or familial polyposis. Clients should be aware of modifiable risk factors as part of general health maintenance and primary disease prevention. Modifiable risk factors are those that can be reduced and include a high fat and low fiber diet."

A nurse is teaching a client about the risk factors associated with colorectal cancer the nurse detemines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? 1. Age younger than 50 2. history of colorectal polyps 3. family history of colorectal cancer 4. chronic IBD

1 is correct. Correctal cancer risk factors include age older than 50, a family history of the disease, polyps, and chronic IBD

The 85 y.o. male client diagnosed with colon cancer asks the nurse, "Why did I get colon cancer?" Which is best response about colon cancer? 1. Lack of fiber in the diet. 2. Greatest incidence among those younger than 50. 3. Has no known risk factors .4. Rare among male clients.

1. Prolonged transit time due to low fiber diet allows for carcinogens to build up in the lumen of colon.

The pt with a new colostomy is being discharged. Which statement indicates a need for further teaching? 1. If I notice any skin breakdown I will call HCP. 2. I should drink only liquids until the colostomy starts to work. 3. I should not take a tub bath until the HCP says it's ok. 4. I should not drive or lift more than 5 pounds.

2. Pt should be on a regular diet with working colostomy for several days before discharge.

The nurse is admitting a male client with a diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment data support this diagnosis? 1. Reports up to 20 bloody stools per day. 2. States he has a feeling of fullness after a heavy meal. 3. Has diarrhea alternating with constipation. 4. Complains of RLQ pain with rebound tenderness.

3 the most common symptoms of colorectal cancer is a change in bowel habits

The nurse is caring for pts in an outpatient clinic. Which info should the nurse teach regarding the American Cancer Society's recommendations for early detection of colon cancer? 1. Beginning at age 60, a digital rectal exam should be done annually.2. After pt reaches middle age, yearly fecal occult test. 3. At age 50, a colonoscopy, then once every 5-10 years. 4. A flexible sigmoidoscopy should be done yearly after age 40.

3- beginning at age 50 patients should have a colonoscopy, if normal repeat every 10 years. If pt has family hx, or polyps/ should be repeated more frequently

The client who has had an abdominal perineal resection is being discharged. Which info should nurse teach? 1. The stoma should be a white, blue, or purple color. 2. Limit ambulation to prevent the pouch from coming off. 3. Take pain meds when pain level is at 8. 4. Empty pouch when 1/3 to 1/2 full.

4. The pouch should be emptied when 1/3 to 1/2 full to prevent leakage and heaviness. pain meds should be taken before pain reaches 5, ambulation should be encouraged. The color of the stoma should be beefy pink.

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite? A) High levels of alcohol consumption B) History of bowel obstruction C) History of diverticulitis D) Longstanding psychosocial stress

Ans: AFeedback:Risk factors include high alcohol intake; cigarette smoking; and high fat, high protein, low fiber diet. Diverticulitis, obstruction, and stress are not noted as risk factors for colorectal cancer.

A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this clients plan of care? a. You may experience nausea and vomiting for the first few weeks. b. Carbonated beverages can help decrease acid reflux from anastomosis sites. c. Take a stool softener to promote softer stools for ease of defecation. d. You may return to your normal workout schedule, including weight lifting.

C ~ Clients recovering from a colon resection should take a stool softener as prescribed to keep stools a soft consistency for ease of passage. Nausea and vomiting are symptoms of intestinal obstruction and perforation and should be reported to the provider immediately. The client should be advised to avoid gas-producing foods and carbonated beverages, and avoid lifting heavy objects or straining on defecation.

A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? a. Eat low-fiber and low-residual foods. b. White rice and bread are easier to digest .c. Add vegetables such as broccoli and cauliflower to your new diet. d. Foods high in animal fat help to protect the intestinal mucosa.

C ~ The client should be taught to modify his or her diet to decrease animal fat and refined carbohydrates. The client should also increase high-fiber foods and Brassica vegetables, including broccoli and cauliflower, which help to protect the intestinal mucosa from colon cancer.

"The most effective treatment method for the nausea and vomiting that accompany chemotherapy is to:" A. Administer an oral antiemetic when the client complains of nausea and vomiting. B. Administer an antiemetic by intramuscular injection when the client complains of nausea and vomiting. C. Administer an antiemetic prior to the antineoplastic medication. D. Push fluids prior to administering the antineoplastic medication."

C. Before starting therapy with agents with high emetic potential, clients may bepretreated with an antiemetic"

A nurse is reviewing the preoperative prescriptions for a client with colon tumor who is scheduled for abdominal perineal resection and notes that the physician has prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication has been prescribed primarily for which of the following purposes? 1. To prevent an immune dysfunction 2. Because the client has an infection 3. To decrease the bacteria in the bowel 4. Because the client is allergic to penicillin

CORRECT ANSWER: 3. To decrease the bacteria in the bowel. Rationale: To reduce the risk of contamination at the time of surgery, the bowel is emptied and cleansed. Laxatives and enemas are given to empty the bowel. Intestinal anti-infectives such as neomycin or kanamycn (Kantrex) are administered to decrease the bacteria in the bowel.

A client has late-stage colon cancer with metastasis to the spine and bones. Which nursing intervention does the nurse add to the care plan to address a priority problem? a. Provide six small meals and snacks daily. b. Offer the client prune juice twice a day. c. Ensure that the client gets adequate rest. d. Give the client pain medications around the clock.

D ~ Although all interventions might be appropriate, a client with late-stage cancer and bone metastases is at risk for severe pain. Giving the client pain medication around the clock is the best way to manage this type of pain.

18. A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale? A) To treat any undiagnosed infections B) To reduce intestinal bacteria levels C) To reduce bowel motility D) To reduce abdominal distention postoperatively

b Antibiotics such a kanamycin (Kantrex), neomycin (Mycifradin), and cephalexin (Keflex) are administered orally the day before surgery to reduce intestinal bacterial. Preoperative antibiotics are not given to treat undiagnosed infections, reduce motility, or prevent abdominal distention.

The occupational health nurse is preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included? 1. Wear a high filtration mask around chemicals. 2. Eat several servings of cruciferous vegetables daily. 3. Take a multivitamin daily. 4. Do not engage in high-risk sexual behavior.

b- increase vegetables daily

While being prepared for a biopsy, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors" a. do not cause damage to adjacent tissue. b. do not spread to other tissues and organs. c. are simply an overgrowth of normal cells. d. frequently recur in the same site

b. do not spread to other tissues and organs. The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors. Benign tumors usually do not recur.

A client with cancer of the colon who is receiving chemotherapy tells a nurse that some foods on the metal tray taste bitter. The nurse would try ti limit which of the following foods that is most likely to cause this taste for the client? " a) cantaloupe b) potatoes c) beef d) custard"

beef: meat is perceived as bitter by clients with cancer

A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer? a. a 37 y o who drinks eight cups of coffee daily b. a 44 y o with irritable bowel syndrome c. a 60 y o lawyer who works 65 hours per week d. a 72 y o who eats fast food frequently

d colon cancer is rare before age 40, incidence increases rapidly with advancing age. fast food tends to be high i fat and low in fiber, increasing risk for colon cancer. coffee intake, IBS, and a heavy workload do not increase the risk for colon cancer

A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patients care in the knowledge of potential complications. What assessment should the nurse prioritize? A) Close monitoring of temperature B) Frequent abdominal auscultation C) Assessment of hemoglobin, hematocrit, and red blood cell levels D) Palpation of peripheral pulses and leg girth

Ans: BFeedback: After bowel surgery, it is important to frequently assess the abdomen, including bowel sounds and abdominal girth, to detect bowel obstruction. The resumption of bowel motility is a priority over each of the other listed assessments, even though each should be performed by the nurse.

"The nurse is planning care for a 68-year-old patient with an abdominalmass and suspected bowel obstruction. Which of the following factors inthe patient's history increases the patient's risk for colorectalcancer?" A. Osteoarthritis B. History of rectal polyps C. History of lactose intolerance D. Use of herbs as dietary supplements"

"B. History of rectal polypsrationale: A history of rectal polyps places this patient at risk for colorectalcancer. This tissue can degenerate over time and become malignant. The other factors identified do not pose additional risk to the patient."

"A patient with metastatic colorectal cancer is scheduled for bothchemotherapy and radiation therapy. Patient teaching regarding thesetherapies for this patient would include an explanation that:" A. Chemotherapy can be used to cure colorectal cancer B. Radiation is routinely used as adjuvant therapy following surgery C. Both chemotherapy and radiation can be used as palliative treatments D. The patient should expect few if any side effects from chemo-therapeutic agents"

"C is Correct. Rationale: Chemotherapy can be used to shrink the tumor before surgery,as an adjuvant therapy after colon resection, and as palliativetreatment for nonresectable colorectal cancer. Radiation therapy may beused postoperatively as an adjuvant to surgery and chemotherapy or as apalliative measure for patients with metastatic cancer."

The client with polyps has watched a video on primary prevention of colon cancer. The nurse can evaluate teaching effectiveness when the client states "I should follow:" 1. low sodium low fat high fiber diet." 2. a low fat, low refined sugar and decrease red meat while eating more fiber." 3. a gluten free, low fat diet." 4. a low carbohydrate, low fat, low tyramine diet.""

"Correct Answer: a low fat, low refined sugar and decrease red meat while eating more fiber." Rationale: The dietary recommendations for the prevention of colon rectal cancer include decreasing the amount of fat, refined sugar, red meats while increasing dietary fiber consumption.

the nurse caring for the pt 1 day post op sigmoid resection notes a moderate amount of dark reddish brown drainage on the midline abdominal incision. Which intervention is first? 1. Mark the drainage on the dressing with the time and date. 2. Change the dressing immediately using sterile technique. 3. Notify the health care provider immediately. 4. Reinforce the dressing with a sterile gauze pad.

1. you should mark the drainage to determine if active bleeding is occuring because dark reddish brown drainage indicates old blood surgical dressing is only changed by surgeon until ordered, always assess before calling the HCP, you may need to reinforce the dressing but only after assessment.

The pt presents with a complete blockage of the large intestine from a large tumor. Which HCP's order would the nurse question? 1. Obtain consent for a colonoscopy and biopsy. 2. Start an IV of 0.9% saline at 125 mL/hr. 3. Administer 3 liters of Go Lytely. 4. Give tap water enemas until it is clear.

3. GoLytely would cause severe cramping and could cause an emergency. Tap water enema is the way to clean out the pt before diagnostic testing.

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider? a. White blood cell (WBC) count of 1500/mm3 b. Fatigue c. Nausea and diarrhea d. Mucositis and oral ulcers

A ~ Common side effects of 5-FU include fatigue, leukopenia, diarrhea, mucositis, mouth ulcers & peripheral neuropathy. However, the client's WBC count is very low (normal range is 5000 to 10,000/mm3), so the provider should be notified. She may want to delay chemotherapy by a day or two. Certainly the client is at high risk for infection. The other assessment findings are consistent with common side effects of 5-FU that would not need to be reported immediately.

A nurse caring for a patient with a newly created ileostomy assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea. What is the nurses priority action? A) Facilitate a referral to the woundostomy continence (WOC) nurse. B) Report signs and symptoms of obstruction to the physician. C) Encourage the patient to mobilize in order toenhance motility. D) Contact the physician and obtain a swab of the stoma for culture.

Ans: BFeedback: It is important to report nausea and abdominal distention, which may indicate intestinal obstruction. This requires prompt medical intervention. Referral to the WOC nurse is not an appropriate short term response, since medical treatment is necessary. Physical mobility will not normally resolve an obstruction. There is no need to collect a culture from the stoma, because infection is unrelated to this problem.

a patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting? A) Apply antibiotic ointment as ordered after cleaning the stoma. B) Apply a skin barrier to the peristomal skin prior to applying the pouch. C) Dispose of the clamp with each bag change. D) Cleanse the area surrounding the stoma with alcohol or chlorhexidine.

Ans: BFeedback:Guidelines for changing an ileostomy appliance are as follows. Skin should be washed with soap and water, and dried. A skin barrier should be applied to the peristomal skin prior to applying the pouch. Clamps are supplied one per box and should be reused with each bag change. Topical antibiotics are not utilized, but an anti fungal spray or powder may be used

A nurse is assessing a patients stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?A) Irrigate the ostomy to clear a possible obstruction.B) Contact the primary care provider to report this finding. C) Document that the stoma appears healthy and well perfused. D) Document a nursing diagnosis of Impaired Skin Integrity.

Ans: CFeedback: A healthy, viable stoma should be shiny and pink to bright red. This finding does not indicate that the stoma is blocked or that skin integrity is compromised.

A patients screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patients health problem? A) Adherence to a high fiber diet will help the polyps resolve. B) The patient should be assured that these are a normal, agerelated physiologic change. C) The patients polyps constitute a risk factor for cancer. D) The presence of polyps is associated with an increased risk of bowel obstruction.

Ans: CFeedback:Although most polyps do not develop into invasive neoplasms, they must be identified and followed closely. They are very common, but are not classified as a normal, age related physiologic change. Diet will not help them resolve and they do not typically lead to obstructions.

A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, "My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How should the nurse respond? a. your doctor should not have given you that information prior to the colonoscopy b. the colonoscopy is required due to the high percentage of false negatives with the blood test c. a negative fecal occult blood test does not rule out the possibility of colon cancer d. i will contact your doctor so that you can discuss your concerns about the procedure

C ~ A negative result from a fecal occult blood test does not completely rule out the possibility of colon cancer. To determine whether the client has colon cancer, a colonoscopy should be performed so the entire colon can be visualized and a tissue sample taken for biopsy. The client may want to speak with the provider, but the nurse should address the clients concerns prior to contacting the provider.

"The night before surgery for colon cancer, the client refuses the bowel preparation and angrily threatens to leave the hospital. Which of the following is the best response?A. "A tranquilizer will help soothe your nerves and make the preparation less painful".B. "I'll call your minister to sit with you until you calm down and take your medications". C. "Tell me what is upsetting you and what I can do to help."D. "I will call the physician to come and talk to you again about the surgery"."

Correct answer: Answer C is the only answer that supports the client and allows the client identify and discuss the issues causing the uncooperative behavior. The nurse understands that cancer surgery in the bowels can cause fears: loss of body function, self-image, and death, etc. and the client needs to verbalize these fears. The other answers assume the client's needs without asking

"During a routine health examination, a 30-year-old patient tells thenurse about a family history of colon cancer. The nurse will plan to:" a. teach the patient about the need for a colonoscopy at age 50 .b. ask the patient to bring in a stool specimen to test for occult blood. c. schedule a sigmoidoscopy to provide baseline data about the patient. d. have the patient ask the doctor about specific tests for colon cancer.

d. have the patient ask the doctor about specific tests for colon cancer. "The patient is at increased risk and should talk with the health careprovider about needed tests, which will depend on factors such as theexact type of family history and any current symptoms. Colonoscopy at age 50 is used to screen for individuals without symptoms or increased risk, but earlier testing may be needed for this patient because of family history. For fecal occult blood testing, patients use a take-home multiple sample method rather than bring one specimen to the clinic. The health care provider will take multiple factors into consideration before determining whether a sigmoidoscopy is needed at age 30."

The nurse is planning care of a client who has had an abdominal perineal resection for colon cancer. Which interventions should the nurse implement? Select all that apply :1. Provide meticlulous skin care to stoma. 2. Assess the flank incision. 3. Maintain the indwelling catheter. 4. Irrigate the JP drains every shift. 5. Position the client semi-recumbent.

1. thorough skin care is needed 3. perineal wound means a catheter to keep urine out of the incision you do not want to sit the patient up right due to pressure on the perineum, JP drains are emptied every shift not irrigated

The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?" a. Duodenal ulcers b. Hemorrhoids c. Weight gain d. Polyps"

Answer D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.

After teaching a client who is recovering from a colon resection, the nurse assesses the client's understanding. Which statements by the client indicate a correct understanding of the teaching? (SATA) a. I must change the ostomy appliance daily and as needed. b. I will use warm water and a soft washcloth to clean around the stoma. c. I might start bicycling and swimming again once my incision has healed. d. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown. e. I will check the stoma regularly to make sure that it stays a deep red color. f. I must avoid dairy products to reduce gas and odor in the pouch.

B, C, D ~ The ostomy appliance should be changed as needed when the adhesive begins to decrease, placing the appliance at risk of leaking. Changing the appliance daily can cause skin breakdown as the adhesive will still be secured to the clients skin. The client should avoid using soap to clean around the stoma because it might prevent effective adhesion of the ostomy appliance. The client should use warm water and a soft washcloth instead. The tissue of the stoma is very fragile, and scant bleeding may occur when the stoma is cleaned. The flange should be cut to fit snugly around the stoma to reduce contact between excretions and the client's skin. Exercise (other than some contact sports) is important for clients with an ostomy. The stoma should remain a soft pink color. A deep red or purple hue indicates ischemia and should be reported to the surgeon right away. Yogurt and buttermilk can help reduce gas in the pouch, so the client need not avoid dairy products.

A nurse cares for a client who has a family history of colon cancer. The client states, "My father & brother had colon cancer. What is the chance that I will get cancer?" How should the nurse respond?a. If you eat a low-fat and low-fiber diet, your chances decrease significantly .b. You are safe. This is an autosomal dominant disorder that skips generations. c. Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer. d. You should have a colonoscopy more frequently to identify abnormal polyps early.

D ~ The nurse should encourage the client to have frequent colonoscopies to identify abnormal polyps and cancerous cells early. The abnormal gene associated with colon cancer is an autosomal dominant gene mutation that does not skip a generation and places the client at high risk for cancer. Changing the client's diet, preemptive chemotherapy, and removal of polyps will decrease the client's risk but will not prevent cancer. However, a client at risk for colon cancer should eat a low-fat and high-fiber diet.

A client has been diagnosed with colon cancer of the rectum. Whilecompleting the preoperative checklist the client asks the nurse "Wherewill my stoma be?" The nurse's best response is A. right upper quadrant. B. left upper quadrant C. right lower quadrant D. left lower quadrant

D) LLQ"Rationale: A client with cancer of the rectum willhave an abdominoperineal resection. The anal canal will be closed and astoma will be formed from the proximal sigmoid colon in the left lowerquadrant of the abdomen. The other 3 answers are in correlation with earlier sections of the colon which is further from the rectum"

"A female client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in nursing plan of care?" a) Monitoring temperature b) Ambulation three times daily c) Monitoring the platelet count d) Monitoring for pathological fractures"

Monitoring the PLT count"Answer: CThrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for the preventing bleeding. Option A elates to monitoring for infection, particularly if leukopenia is present. Option B & D, although important in the plan of care, are not related directly to thrombocytopenia."

A nurse cares for a client with colon cancer who has a new colostomy. The client states, "I think it would be helpful to talk with someone who has had a similar experience." How should the nurse respond? a. I have a good friend with a colostomy who would be willing to talk with you. b. The enterostomal therapist will be able to answer all of your questions. c. I will make a referral to the United Ostomy Associations of America. d. You'll find that most people with colostomies don't want to talk about them.

C ~ Nurses need to become familiar with community-based resources to better assist clients. The local chapter of the United Ostomy Associations of America has resources for clients and their families, including Ostomates (specially trained visitors who also have ostomies). The nurse should not suggest that the client speak with a personal contact of the nurse. Although the enterostomal therapist is an expert in ostomy care, talking with him or her is not the same as talking with someone who actually has had a colostomy. The nurse should not brush aside the client's request by saying that most people with colostomies do not want to talk about them. Many people are willing to share their ostomy experience in the hope of helping others.

A client undergoes a colonoscopy for colorectal cancer screening. During the procedure three small polyps were removed. Which nursing procedures are necessary when caring for the client immediately after the colonoscopy? " A. Monitor vital signs and inform her that there may be a small amount of blood in her stool. B. Observe for signs and symptoms of bowel perforation, monitor vital signs, and inform her that there may be a small amount of blood in her stool and to report excessive blood loss. C. Observe for signs and symptoms of bowel perforation, monitor vital signs, and inform her to follow a clear liquid diet .D. Monitor vital signs and inform her that there may be a small amount of blood in her stool, and tell her not to drive for two days."

1. B - Rationale: After a colonoscopy the nurse should observe the patient closely for signs of bowel perforation (rectal bleeding, abdominal pain and distention, malaise, fever, and mucopurulent drainage). Vital signs should be monitored until stable. Due to the polyp removal, there may be some blood, but excessive bleeding is not expected and must be reported. As well as monitoring vital signs and instructing the patient that a small amount of blood may be present, it is very important to educate and instruct to report excessive blood loss. The patient may resume a normal diet but is instructed to increase fluid intake due to fluids lost through laxatives and the NPO period. The patient should not drive for several hours after the procedure, until effects of any sedatives have worn off.

A nurse cares for a client newly diagnosed with colon cancer who has become withdrawn from family members. Which action should the nurse take? a. Contact the provider and recommend a psychiatric consult for the client. b. Encourage the client to verbalize feelings about the diagnosis .c. Provide education about new treatment options with successful outcomes. d. Ask family and friends to visit the client and provide emotional support.

B ~ The nurse recognizes that the client may be expressing feelings of grief. The nurse should encourage the client to verbalize feelings and identify fears to move the client through the phases of the grief process. A psychiatric consult is not appropriate for the client. The nurse should not brush aside the client's feelings with discussions related to cancer prognosis and treatment. The nurse should not assume that the client desires family or friends to visit or provide emotional support.

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action should the nurse take? a. Ask if the client is experiencing pain in the right shoulder. b. Perform a rectal examination and assess for polyps. c. Contact the provider and recommend computed tomography. d. Administer a laxative to increase bowel movement activity.

c the presence of visible peristaltic waves, accompanied by high pitched or tingling bowel sounds, is indicative of partial obstruction caused by the tumor. Contact PCP and recommend a computed tomography scan.

"The nurse is performing an admission assessment on a client diagnosed with a right colon tumor. The nurse asks the client about which characteristic symptom of this type of tumor?" a) rectal bleeding b) flat, ribbon-like stool c) crampy, colicky abdominal pain) d) alternating constipation and diarrhea"

c) crampy, colicky abdominal pain)Vague abdominal discomfort or crampy, colicky abdominal pain is a characteristic symptom of a right colon tumor. Options A, B, and D are symptoms associated with left colon tumors.