Case #2 A 63-year-old man complains of dyspnea and chest pain on exertion.

His current
symptoms have been present for approximately 3 to 4 weeks. Over approximately the same
period, the patient has noted post-prandial bloating in his abdomen. His past medical history is
significant for hypertension and stable angina. On physical examination, he appears well-
nourished and in no acute distress. The abdominal examination reveals an obese abdomen
without masses or tenderness. The rectal examination reveals no rectal masses, a smooth and
mildly enlarged prostate gland, and strongly Hemoccult-positive stool in the rectal vault. His
complete blood count reveals normal WBC count, hemoglobin 8.2 g/dL, hematocrit 28.5%, and
mean cell volume 72 fL (normal range, 76-100 fL). The electrolytes and liver function tests are
within normal limits. A 12-lead ECG reveals normal sinus rhythm with mild left ventricular
hypertrophy. A chest x-ray reveals normal cardiac silhouette, no pulmonary infiltrations, no
pleural effusion, and no pulmonary masses.

 Summary: A 63-year-old man presents with a recent onset of dyspnea on exertion, chest
pain, and nonspecific gastrointestinal tract complaint related to occult GI blood loss and
possibly mild mechanical obstruction symptoms.
 Most likely cause: The combination of anemia and post-prandial bloating are compatible
with symptoms produced by colorectal (CRCs) cancers.
 Confirmation of diagnosis: GI endoscopy, with esophagogastroduodenoscopy (EGD) to
evaluate the upper GI tract and colonoscopy to evaluate the lower GI tract. Biopsies of
abnormalities are important for tissue diagnosis.

Objectives:
1. What is the normal anatomy and physiology of the affected body part?
2. What is the disease's pathophysiology?
3. What assessment and evaluation factors, diagnostic procedures, and imaging
techniques are utilized to detect the disease?
4. What is the recommended Surgical Management for the case?
5. Create a Preoperative, Postoperative, and Discharge Nursing Care Plan.