Question

what lab values would you expect to find on a patient with stage II colon cancer?
A patient is having a partial colectomy for stage II colon cancer.
-what physician orders would you expect for this (pre and post-op)?
-what nursing interventions would you implement?

Answer 1

●Stage II cancer affects just the colon and has not metastasized. So it can be cured.Blood test will not provide a confirmatory diagnostic procedure but it can provide some basic changes to suspect colon cancer

• CBC:elevated WBC, decreased platelets ,decreased hemoglobin, decreased RBC
• CEA:(Carcinoembryonic antigen) levels are increased in colon cancer
• CA 19.9 is positive
• FOBT (Fecal occult blood test ) shows the presence of blood in the feces
• Alteration in liver function test and renal function(decreased albumin) test can be observed along with other lab values

●The pre op orders and g intervention are

• Blood investigations (all routine tests like Complete blood count, renal and liver function test, clotting factors, urine routine,stool routine and culture,HIV,HCV,Hepatitis B,Blood grouping and cross matching,chest x ray)
• Initiation of antibiotics preoperatively to prevent infection
• Bowel preparation (mechanical bowel preparation) with polyethylene glycol enema, Nichols Condon bowel preparation consisting of erythromycin and neomycin
• Nil by mouth from the midnight
• Carbohydrates are given in rich and calculated quantities to prevent post op complications

The post op care are

• Administer pain killers routinely to relieve pain
• Maintain fluid balance to prevent fluid loss or excess
• Keep patient NBM till the bowel movements or bowel sounds
• Starts with clear liquids and gradually to higher diets as per order and patient tolerance
• Support psychologically to come out of the painful experience
• Ambulate the patient earlier to prevent complications