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APA
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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Topic:

Discharge And Self Management Of Colorectal Cancer (Case Study Sample)

Instructions:

The sample is about John who is a 65-yer-old man who has colorectal cancer and the cases study is about the Discharge plan that should put in place after he leaves the chemotherapy facility. Furthermore, the article identifies the education and management plan that is relevant in ensuring the full recovery of john and identifying any sings of recurrence of the cancer.

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Discharge and Self-management of Colorectal Cancer
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Introduction
John started his health kick on his 65th birthday though he did not get involved in any particular sport and never did do any regular exercises. Moreover, John did not have a healthy eating habit because most of the weekends he spent time with his friends drinking a few beers and eating a lot of beef content with was rarely backed up by greens. After John got diagnosed, he suffered from a high anterior resection which he acquired after colorectal cancer got located in his colonoscopy which involves the evaluation of the inside of the colon. Furthermore, John had the history of ACPS B which was poorly differentiated from the adenocarcinoma infiltrating the serosa. Also, John admits that he had experienced pains and he felt tired frequently. This article also provides information regarding the discharge plan John can follow after leaving the hospital and the self-management plan he can follow to ensure that he fully completes his active treatment.
Discharge Plan
The Recommended Follow up Regime
According to Jorgensen (2015), most of the follow-up regime gets recommended for patients who have received curative resection for stages 2 and stage 3 diseases; this puts John at risk of acquiring Primary Colorectal Cancer and adenomatous polyps. Hence, there are possibilities that John may develop a new primary cancer and adenomas which may reoccur after about four years. Furthermore, the follow-up regime is crucial because it would help John maintain a good healthy life which manages the side effects of the chemotherapy. In the follow-up regime, it is essential for John to receive the history and physical examination from a physician at regular intervals to establish the symptoms of colorectal cancer recurrence. Furthermore, the digital rectal exam is also done on selected patients to develop rectal cancer. It is vital that follow up on this history, physical examination and digital rectal examination be done at intervals of three to six months for the two years then six months to a year after that. Also, sigmoidoscopy should get done, and it is essential for John to have this because he had an anterior section of the rectum and the test is recommended every six months to check any abnormalities.
Furthermore, Carcinoembryonic Antigen (CEA) testing should be done at each follow-up visit because the CEA is a protein which is essential in patient's blood elevation. Furthermore, it can indicate colorectal cancer recurrence before even the signs and symptoms are evident. The CEA should get done at intervals of three to six months for five years (Steele, 2015). Moreover, Computed Tomography (CT) scan should also be done which creates a three image dimension of the body inside with the use of an x-ray machine and it is recommended for the abdomen and chest yearly for every six to 12 months for the first three years. The CT scan also helps in detecting metastatic diseases which may be present in the liver and lungs (Smetana, 2015).
Moreover, colonoscopy should get done to detect any polys or metachronous CRC and anastomotic recurrence in the rectum and the large bowel. It is essential for the colonoscopy to be done one year after the rectum resection and how often John needs this test depends on the results of the examinations that were made earlier though most of the colonoscopy gets done after every five years. The signs and symptoms that most colorectal cancer recurrence patients face are depression and anxiety which are often due to the fear of cancer recurring. Moreover, some patients suffer from sexual dysfunction and erectile dysfunction, and these can only get managed by seeking medical advice from concerned specialists (Ekholm, 2013).
Education and Self-management Plan
1 Physical Needs
According to Ose (2017), John may experience bowel movement, constipation and diarrhea and it is essential that the coordinator educates him to identify these symptoms and seek medical interventions from stomal therapists and continence specialists. Furthermore, John may experience flatus and odors due to fecal and urinary fistulae, and it is essential that he know how to identify these signs so that he may seek medical attention from health care specialists concerned. Moreover, the patient may experience reduced interest in sex and sexual dysfunction which is most common in stoma patients (Averyt, 2014). Therefore, it is essential that John knows how to identify this symptom and seek medical attention from concerned specialists before the medical condition worsens. Also, the patient may lose weight due to change in food appetite which is a critical issue which John is required to manage by seeking medical advice from a dietitian (Ho, 2016). John may also experience nausea and severe vomiting which are the severe side effect of the colorectal cancer therapy. Hence, it is crucial that John knows how to manage this medical issue by seeking medical attention from specialists and this will enable improvement in his health. Furthermore, John may face ejaculation and erectile dysfunction which are sensitive issues of discussion, and he should get advised that seeking medical attention from the appropriate specialist is the best way to manage the situation (Lindau, 2016). Most of the physical needs that John may encounter may require pharmaceutical help, and it is advisable that he seeks medical advice in case of any symptoms that he notes.
2 Psychological Needs
According to Wiljer (2013), anxiety, mental distress, and depression are common in colorectal cancer patients and patients with stomas. Hence, it is essential that John seeks medical advice from a psychiatrist who will do screening on patients which will identify any risks of anxiety and depression. Furthermore, John may face the fear of colorectal cancer recurrence which is often after the completion of his treatment. Therefore, it is crucial that he seeks medical advice from a psychologist if these symptoms begin to creep in and the specialist will help him manage this situation effectively. Moreover, bowel cancer may cause post-traumatic distress on the patients because of the intense cancer treatment program, and it is critical that John knows to identify this symptom so that he may seek appropriate medical attention from the concerned specialists (Russell, 2015). If John experiences depression it is therefore essential that he gets information on how to be calm and the relaxation techniques he can use so that he can recover fully from cancer. It is important because depression may cause John to be alcoholic since he spends most of his weekends drinking beer with his friends watching games.
3 Social Needs
Many of the patients who have any cancer may find it difficult to relate to their loved ones and friends while other cancer patients may face financial strain due to difficulty in coping with their job demands. It is often caused by depression that which may lead to John being isolated and stop interacting with his friends. In case these occur, it is essential that John seeks medical advice from the psychologist who will help him manage the condition (Rosenberg, 2016).
4 Spiritual Needs
Some colorectal cancer patients and their families may need spiritual advice regarding how they can manage their loved one's condition; it is, therefore, essential that they seek help from appropriate spiritual caregivers who will help them through the cancer journey. Hence, in case John and his family experience a need for spiritual interventions he may seek this from spiritual caregivers who will help him with the cancer journey and the recovery process.
Principles on Effective Discharge and Self-management communication and Strategies
According to Lithner (2015), it is the responsibility of the Cancer Care Coordinator to ensure that proper communication is made to address the needs of the patient and his or her family get met. It is essential that the coordinator notes that different cancer patients need different communication needs. Moreover, the communication with the cancer patient should be individualized, transparent and in plain language which does not comprise complicated medical terms that will create a good understanding. Also, the communication made by the coordinator should get delivered in the appropriate setting where the patient, family of the patient and the caregivers can be present (Lithner, 2015). The communication that the coordinator gives should get focused on listening to the patients and encouraging that will improve the emotional, psychological and physical need of the patient (Ohlsson-Nevo, 2017). It is also crucial that the communication be a two-way where the John and his family can ask questions so that they may understand the needs and the follow-up regime that he needs to follow to ensure he recovers fully.
Conclusion
This article gives the precise steps and guidelines that John can follow to ensure that he recovers fully from cancer and the chemotherapy that he underwent. Moreover, the article evaluates the intervals in which John should get the follow-up regime to ensure that he recovers fully from colorectal cancer. Also, the report identifies the principle effective communication strategies that the coordinator will use to that John understands how the follow-up regime is going to take place effectively. Moreover, the signs and symptoms of colorectal cancer recurrence may include sexual dysfunction and John may seek medical attention in case this happens (Breukink, 2013). Hence, ...
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