need help with an assignment

  1. Hi, im first year nursing student and just want some help with a case study assignment im doing. I need a nurses opinion. my case study is about a man coming in with all symptoms that point to colon cancer, his blood pressure is low, pulse high and respiration high. can anyone help me with why his pulse rate and respiration's would be high in relation to his colon cancer? would it be because of loss of red blood cells?
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    About jane931

    Joined: Mar '18; Posts: 7; Likes: 1
    Specialty: 1 year(s) of experience

    12 Comments

  3. by   PudgeMC
    If his H&H is low then yeah, that with the vitals is consistent with a bleed somewhere. If he's in pain, than all of those things would be elevated as well (except BP would be elevated.) Need more pieces of this puzzle to determine those things though.
  4. by   Triddin
    Any infection? What has his intake been?
  5. by   jane931
    Thanks. The case study its self is to diagnose a patient, it says ' a man has been admitted to your ward following a gp visit he has shortness of breath, pale and history of weight loss, night sweats, melaena and irregular bowel movements. He is a smoker. His obversations on admission are temp 36, pulse 104, resps 30, blood pressure 90/60, and oxygen saturation 90%'
    it came with a few different questions but one was to explain his observations and why they are what they are. I related it back to anemia being common in colon cancer patients due to loss of red blood cells but just wasn't sure if that was correct as I'm still pretty new to this.
  6. by   Triddin
    Quote from jane931
    Thanks. The case study its self is to diagnose a patient, it says ' a man has been admitted to your ward following a gp visit he has shortness of breath, pale and history of weight loss, night sweats, melaena and irregular bowel movements. He is a smoker. His obversations on admission are temp 36, pulse 104, resps 30, blood pressure 90/60, and oxygen saturation 90%'
    it came with a few different questions but one was to explain his observations and why they are what they are. I related it back to anemia being common in colon cancer patients due to loss of red blood cells but just wasn't sure if that was correct as I'm still pretty new to this.
    So the Melena, hypotension, increased hr and rr, paleness make me suspicious about a current gi bleed. I would want to know his hgb stat. Melena means current bleed. There could be an anemia aspect, but it isn't your most pressing concern at the moment. What could be happened no is that the patients cancer has perforated a blood vessel and is actively bleeding. He is currently compensating for a low circulation volume/ (likely) low hgb with increasing rr and hr.

    Weight loss for sure (and I think) night sweats can be attributed to cancer, but again, not your pressing problem
  7. by   jane931
    Awesome that helped heaps and just made my mind start thinking deeper! Thank you so much!
  8. by   QuietIsntAWord
    Are you supposed to medically diagnose this patient or have a nursing diagnosis? Both are very different things.
  9. by   UCFAshley
    All those symptoms don't point to colon cancer but the body's response to compensate for low oxygenation and ineffective perfusion to body tissues. Colon cancer is a medical diagnosis and I assume your instructor is looking for a nursing diagnosis.
  10. by   jane931
    Yes sorry the last bit of the case study says 'a suspected carcinoma in situ' and yes other parts of the assignment are what diagnostic test will be done to treat this and what results would you need to see and also what treatment and medication therapy will he receive.
  11. by   jane931
    Sorry to confirm* this suspicion of carcinoma in situ.
  12. by   Have Nurse
    You need to study this disease, its' symptoms and its' course, treatments, etc. Don't expect us to do your homework, Sweetheart. You can do it. Just dig in....
  13. by   Orion81RN
    Quote from Triddin
    So the Melena, hypotension, increased hr and rr, paleness make me suspicious about a current gi bleed. I would want to know his hgb stat. Melena means current bleed. There could be an anemia aspect, but it isn't your most pressing concern at the moment. What could be happened no is that the patients cancer has perforated a blood vessel and is actively bleeding. He is currently compensating for a low circulation volume/ (likely) low hgb with increasing rr and hr.

    Weight loss for sure (and I think) night sweats can be attributed to cancer, but again, not your pressing problem
    This! Think about the physiology. Increased heart rate is the body's way of conpensation for decreased fluid volume (thus decreased oxygen to tissues.) The heart beats faster to circulate blood and perfuse tissue with oxygen. Respiratory rate is increased because your body is saying it needs more oxygen. Those 2 vital signs combined with pt's history make me suspect GI bleed. Always go back to basics. A&P. You were really close, just now need to apply A&P at a deeper level.
  14. by   jane931
    Quote from Have Nurse
    You need to study this disease, its' symptoms and its' course, treatments, etc. Don't expect us to do your homework, Sweetheart. You can do it. Just dig in....
    I wasn't expecting anyone to do my assignment for me 'sweetheart' I was only asking if I was on the right track about the loss of blood! And the first person answered that for me straight away and I've continued and finished it now.....

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