need help with an assignment

PudgeMC, ADN · Mar 8, 2018

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.

Triddin · Mar 8, 2018

Any infection? What has his intake been?

jane931 · Mar 8, 2018

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.

Triddin · Mar 8, 2018

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

jane931 · Mar 8, 2018

Awesome that helped heaps and just made my mind start thinking deeper! Thank you so much!

QuietIsntAWord · Mar 8, 2018

Are you supposed to medically diagnose this patient or have a nursing diagnosis? Both are very different things.

UCFAshley · Mar 8, 2018

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.

jane931 · Mar 8, 2018

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.

jane931 · Mar 8, 2018

Sorry to confirm* this suspicion of carcinoma in situ.

Have Nurse, ADN, RN · Mar 9, 2018

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....:)

Orion81RN · Mar 9, 2018

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.