Colon Cancer Case Study

OUR LADY OF FATIMA UNIVERSITY
120 MacArthur Hwy, Valenzuela, 1440 Metro Manila
A CASE STUDY OF COLON CANCER
Submitted to the Nursing Service Department of Quezon City General Hospital as a

Partial Requirement in MS Ward Duty
Submitted by:
Group 3C
De Guzman, Muriel
Dela Cruz, Angelo
Dela Cruz, Gilson
Florindo, Louisiana
Galila, Cyvren
Gatuz, Sarah Mae
Group 3D
Gomez, Shennah Kyra
Gonzales, Cesar Nestor
Hipolito, Joana Mae
Joson, Sophia Chrischelle
Juat, Patricia Ellise
Mamacos, Francoise Caseyliam
Submitted to:
Mrs. Almira Gabriel, RN, MAN
January 2023
INTRODUCTION
The Colorectal Cancer
Evidently, colorectal cancer, which describes co-occurring colon cancer and rectal
cancer, is common causes of mortality and morbidity throughout the world regardless of
numerous reliable screening tools and therapies available. Many patients with colon
cancer are diagnosed in early stages (stages I to III), but in this case study, the patient is
already in the late stage when diagnosed which makes it have a less opportunity for
cure. Stage 4 colon cancer is when the cancer cells present in the colon extend to other
parts of tissues and organs.
Clinical Characteristics & Tests
The symptoms of colon cancer vary on which type of cancer it is, how big is the
size, and whether it has spread to any other parts making it as important to get checked
if you have experienced the following: (1) changes in bowel habits, (2) rectal bleeding, (3)
presence of blood in the stool, (4) abdominal pain, (5) weakness & fatigue, and (6) weight
loss. For some instances, it does not show symptoms until the cancer cells are spread
out and grown; therefore, it is best to be tested earlier if there are suspicious symptoms.
Many screening tests and examinations may be done to confirm a colon cancer, but this
is depending on your symptoms. Doctors might order tests such as protein tests, gene
tests, colonoscopy, biopsy, CT scan, and ultrasound.
Epidemiology
As discussed lately, colon cancer is already the common cause of death in the
world. Its incidence is increasingly rising in developing nations. Main factor is genetic, but
it could also be a cause of dietary failure. According to GLOBOCAN (2018), colon cancer
is the topmost incident cancer in the world. Colon is the fourth most common incident
while rectal cancer is the eighth most incident. Making colorectal cancer as the third most
common diagnosed form of cancer globally.
ANATOMY AND PHYSIOLOGY
The colon is also referred to as the large intestine or large bowel. It is an organ
that is a part of the human body's digestive system, which is also known as the digestive
tract. To eliminate feces and keep the body's fluid and electrolyte balance, it works with
organs like the stomach and small intestine. When it comes to how our bodies utilize the
food we eat, the colon plays a crucial role. The large intestine begins its connection to the
small intestine, the cecum. Then the rest of the colon's body portion is followed by five
sections, which are:
• Ascending colon - the hepatic flexure of the cecum marks the beginning of the
ascending colon, which measures about 10 cm in length. It connects with the
transverse colon along the right side of the abdomen.
• Transverse colon - which is 50 cm long, located adjacent to the gallbladder, liver,
and stomach. The distal, or left-sided, a portion of the large intestine joins to this
via the descending colon.
• Descending Colon - roughly 10 cm long, the downward left portion of the colon
connects the transverse colon to the sigmoid colon.
• Sigmoid colon - the colon's S-shaped portion that links to the rectum.
• Rectum - the section of the large intestine that starts at the sigmoid colon, follows
it, and finishes at the anus.
PATHOPHYSIOLOGY
The transformation of the normal colonic epithelium to a precancerous lesion

(adenoma and ultimately to invasive carcinoma requires an accumulation of genetic
mutations either somatic (acquired) and/or germline (inherited). The theory of colonic
carcinogenesis features a clonal mutation evolution that gives a cell survival-immortality
advantage and allows to develop more mutations providing other cancer hallmarks such
as proliferation, invasion, metastasis, and others. Clinical evidence has shown that
colorectal cancer frequently arises from adenomatous polyps that typically acquire
dysplastic changes in a 10 to 15-year period before developing invasive carcinoma, and
the early detection-removal of polyps will reduce the incidence of colorectal cancer.
New evidence has exposed that hamartomatous and serrated polyps could lead
to colorectal cancer. There are three major molecular pathways linked to colorectal
cancer: (1) chromosomal instability; (2) mismatch repair, and; (3) hypermethylation. The
chromosomal instability pathway is a gain of mutations unbalancing oncogene and tumor
suppressors equilibrium as seen with mutations in the adenomatous polyposis coli. Cells
with deficiency of DNA mismatch repair, commonly MLH1 or MSH2, accumulate errors
within the genome that further will be repeated causing high levels of microsatellite
instability, a hallmark of Lynch syndrome. CpG hypermethylation of DNA could activate
or silence the expression of certain genes, Sporadic oncogenes somatic mutations have
been implicated in colorectal cancer, with RAS the most clinical relevance. RAS mutation
variants are found in 50% of colorectal cancer sporadic cases, currently being exploited
on colorectal cancer screening by stool-DNA testing, the absence of epidermal growth
factor receptors, targeted therapy response and potential direct targeted agents. In the
other hand, tumor suppressors genes require bi-allelic loss (“two-hit model”) and are
described in loss of APC 5q21 gene (80% sporadic), TP53 17p gene (50-70% sporadic),
and DCC/SMAD2-4 18q gene (73% sporadic). Specific MMR gene mutations could occur
in hMSH2, hMLH1, hPMS1 and hPMS2, hMSH6, and hMLH3; each one of them that
interact with MLH1 and approximately found in 15% of all sporadic CRC causing a Lynch-
like syndrome with MSI-H calling for universal testing. MUTYH defects have a recessive
inheritance pattern at a time requiring bi-allelic second hits or in conjunction with APC
gene mutation. Cyclooxygenase and peroxisome proliferator–activating receptor genes
have been implicated in colorectal cancer tumorigenesis currently under investigation for
chemo-protection.
PHYSICAL ASSESSMENT
Subjective:
• (-) chest pain
• (-) abdominal pain
• (-) melena/ hematochezia
• (-) dysuria
Objective:
• Bp 90/60
• HR 89
• RR 16
• T 36.5
• O2 sat 98% at room air
Nurses’ Observation:
• Awake, conscious coherent, not in respiratory distress
• (+) icteric sclera, pink palpebral conjunctiva (-) neck vein distention
• (-) cervical lymphadenopathy
• Symmetrical chest expansion (-) retractions (-) lagging, clear breath sounds
• Adynamic precordium, normal rate, rhythm, (-) murmur
• Flabby, normal abdominal bowel sounds, tympanitic on all quadrant, non-tender,
liver span 20cm from the midline
• (-) edema, full equal pulses
• (+) dry extremities
• Gcs 15 (e4v5m6)
Impression: Urosepsis
LABORATORY AND DIAGNOSTIC PROCEDURES
Arterial Blood Gas
Units Results Normal Indications Interpretations

Values
pH --- 7.460 7.35 - 7.45 High Increase in potential hydrogen

level
pCO2 mmHg 27.1 35 - 45 Low Decrease in partial pressure of

carbon dioxide level
pO2 mmHg 62.5 80 - 100 Low Decrease in partial pressure of

oxygen level
HCO3 mEq/L 18.8 22 - 26 Low Decrease in bicarbonate level
FE mEq/L -5.0 -2 to +2 Low Decrease in serum iron level
O2Sat % 93.5 90 - 100 --- ---
Hematology
CBC Units Results Normal Indications Interpretations

Values
WBC x10^3/uL 37.55 3.5 - 9.5 High Increase in white

blood cells
RBC x10^6/uL 2.85 4.3 - 5.8 Low Decrease in red

blood cells
Hemoglobin g/L 86 120 -160 Low Decrease in

hemoglobin
Hematocrit % 25.8 40 - 50 Low Decrease in

hematocrit
MCV fL 90.5 82 - 100 --- ---
MCH pg 30.2 27 -34 --- ---
MCHC g/L 333 316 - 354 --- ---
Platelet x10^3/uL 142 150 - 400 Low Decrease in platelet
Differentiate
Count
Neutrophils % 95.8 40 - 75 High Increase in

neutrophils
Lymphocytes % 1.9 20 - 50 Low Decrease in

lymphocytes
Monocytes % 2.1 3 - 10 Low Decrease in

monocytes
Eosinophils % 0.1 0.4 - 8 Low Decrease in

eosinophils
Basophils % 0.1 0-2 --- ---

Clinical Chemistry
Units Results Normal Indications Interpretations

Values
BUN mmol/L 7.51 2.14 - High Increase in blood urea

7.14 nitrogen level
Creatinine umol/L 68.63 62 – 106 --- ---
Sodium mmol/L 137.4 135 - 155 --- ---
Potassium mmol/L 3.61 3.4 - 5.3 --- ---
Ionized mmol/L 1.36 1.13 - High Increase in serum

Calcium (ISE) 1.32 ionized calcium level
Chloride mmol/L 110.70 98 -106 High Increase in serum

chloride level
Magnesium mmol/L 0.69 0.66 - --- ---

1.07
Procalcitonin ng/mL 5.96 0 - 0.30 High Increase in serum

(ECLIA) procalcitonin level
ALP U/L 302.36 40 - 130 High Increase in serum

alkaline phophatase
level
Total Bilirubin umol/L 126.44 0 - 21 High Increase in total

bilirubin
Direct Bilirubin umol/L 107.85 0-5 High Increase in direct

bilirubin
---
Indirect umol/L 18.59 --- ---
Bilirubin
TPAG
Total Protein g/L 46.53 64 - 83 Low Decrease in total

protein
Albumin g/L 15.71 35 - 52 Low Decrease in albumin
Globulin g/L 30.82 --- --- ---
A/G Ratiio g/L 0.51 0.82 - 2 Low Decrease in a/g ratio
Clinical Microscopy
Procedure Result
Fecal Occult Blood Test Positive

DRUG STUDY
MECHANI NURSING
DRUG CLASSIFICAT INDICATIO CONTRAINDICA SIDE
SM OF RESPONSIBILI
NAME ION N TION EFFECTS
ACTION TIES
Generic Belongs to the Meropene Wide Meropenem is More 1. Assess
name: class of m exerts spectrum contraindicated in common patient for
Meropen carbapenems. its antibiotic patients with previous
em bactericida used to known • Constipa sensitivity
Used in the l action by treat both meropenem tion reaction to
Brand systemic binding to Gram- hypersensitivity, a • redness carbapenems
name: treatment of penicillin- positive history of and
Merrem infections. binding and Gram- carbapenem swelling 2. Assess
proteins negative hypersensitivity, at the patient for signs
(PBPs) in infections or a previous injection and symptoms
the including anaphylactic site of infection,
bacterial pseudomo reaction to beta- Less including
cell wall nas spp. lactams. common characteristics of
and resistant to wounds,
inhibiting other •
Body sputum,urine,
peptidogly antibiotics. aches or stool.
can cross- Use to pain
linking treat • cold 3. Complete C/S
associated infections hands tests before
with cell like and feet beginning drug
wall meningitis, • cold therapy
synthesis, pneumonia sweats
which and intra- • congesti 4. Assess for
ultimately abdominal on allergic
leads to infections, • cool pale reactions,
cell death. complicate skin anaphylaxis
d skin/skin • dryness
structure or 5. Identify urine
infections. soreness output
of the
throat 6. Monitor blood
• increase studies
d hunger
• indigesti 7. Monitor
on electrolytes
• nightmar
es 8. Assess bowel
pattern daily
9. Monitor for
bleeding
NURSING
DRUG CLASSIFICAT MECHANISM INDICATI CONTRAINDICA SIDE
RESPONSIBILI
NAME ION OF ACTION ON TION EFFECTS
TIES
1. Assess for
level of pain
relief and
administer PRN
dose but not to
exceed the
recommended
total daily dose.
2. Monitor VS
and assess for
orthostatic
hypotension or
signs of CNS
depression.
• Constipa
Hypersensitivity to tion 3. Discontinue
tramadol or • Nausea drug and notify
Generi Binds to
opioids. Known or • Dizzines physician if S
c muopioid
suspected s &S of
Name: receptor.
Relief of gastrointestinal hypersensitivity
Trama • Analgesic Inhibits • Vertigo
moderate obstruction, occur.
dol (Centrally reuptake • Headach
to including paralytic
acting) of e
moderatel ileus. Concurrent 4. Assess bowel
Trade • Opioid serotonin
y severe use of • Drowsin and bladder
Name: analgesic and ess
pain monoamine function; report
Ultram norepinep • Vomiting
oxidase inhibitors urinary
hrine in the • Agitation
(MAOIs) or use frequency or
CNS. • Anxiety
within last 14 retention
days. • Mood
swings 5. Use seizure
precautions for
patients who
have a history of
seizures or who
are concurrently
using drugs that
lower the
seizures
threshold.
6. Monitor
ambulation and
take appropriate
safety
precautions.
MECHANI NURSING
DRUG CLASSIFICAT INDICATIO CONTRAINDICA SIDE
SM OF RESPONSIBILI
NAME ION N TION EFFECTS
ACTION TIES
• Tremor
It is used to s/
treat the shaking
symptoms in your
of slow arms/le
stomac gs
emptying • Confusi
It on 1. Monitor BP
(gastropare
promotes • Depres carefully during
sis) in
gut motility sion IV
patients
by the • Thought administration
with
following 3 s of
diabetes.
mechanis Patient with suicide 2. Monitor for
Metoclopramid ms: (1) pheochromocyto extrapyramidal
• Slow/jer
e is in a class Inhibition ma because the reactions and
It works by ky
Generic of medications of drug may cause a consult
increasing mucle
Name: called presynapti hypertensive physician if they
the movem
Metoclopra prokinetic c and crisis, probably occur.
movements ents in
mide agents. It postsynapt due to release of
or your
works by ic cathecholomines 3. Monitor
contraction face
Brand speeding the excitatory from the tumor. diabetic
s of the • Convuls
Name: movement of 5-HT4 Such patients,
stomach ion
Reglan food through receptors hypertensive arrange for
and (seizure
the stomach and crises may be alteration in
intestines. )
and intestines. antagonis controlled by insulin dose or
m of phetolamine. • Anxiety timing if diabetic
It relieves • Agitatio
presynapti control is
sypmtoms n
c inhibition compromised by
such as • Jittery
of alterations in
nausea, feeling
muscarinic timing of food
vomiting, • Trouble
receptors. absorption.
heatburn, a staying
feeling of still
fullness • Sleep
after meal problem
and loss of s
appetite. (insomi
a)
MECHANI NURSING
DRUG CLASSIFICA CONTRAINDIC SIDE
SM OF INDICATION RESPONSIBIL
NAME TION ATION EFFECTS
ACTION ITIES
Hydrochlo • Eradicatio
ric acid n of H.
(HCl) Pylori to
secretion reduce
into the the risk of
gastric duodenal CNS:
lumen is a ulcer • Dizzine
process recurrenc ss
regulated e in adult. • Drowsin
mainly by • Tx of ess 1. Monitor GI
the active • Fatigue symtoms to
H(+)/K(+) benign • Headac help determine
– ATPase gastric he if drug therapy
of the ulcer in • Weakne is successful.
proton adults ss
pump • Tx of 2. Assess
Generic expressed symptom CV: dizziness that
Name: in high atic Patients with • Chest might affect
Omeprazole It is in a class quantities GERD in history of pain gait, balance
of by the patients 1 hypersensitivity and other
Trade medications parietal year of to drug such as GI: functional
Name: called proton- cells of age and anaphylactic activities.
• Abdomi
✓ Losec pump the older shock,
nal pain
✓ Omecla inhibitors. It stomach. • Tx of angioedema, 3. Caution the
• Acid
mox works by erosive interstitial patient and
regurgit
✓ Omese decreasing ATPase is esophagit nephritis, family to guard
ation
c the amount of an is (EE) d/t anaphylaxis, against falls
✓ Prevido acid made in enzyme urticaria and • Constip and trauma.
acid-
lrx the stomach. on the bronchospasm ation
mediated
✓ Analge parietal GERD in may occur. • Diarrhe 4. Monitor other
sic Pak cell patients 1 a CNS side
membran month of • Flatulen effects and
e that age and ce report severe
facilitates older • Nausea or prolonged
hydrogen • Maintena • Vomitin effects.
and nce of g
potassium healing of 5. Monitor any
exchange EE d/t SKIN: chest pain.
through acid • Itching
the cell, mediated • Rash
which GERD.
normally • Pathologi
results in c
the hypersecr
extrusion etory
of conditions
potassium in adults.
and
formation
of HCl
(gastric
acid).
MECHANI NURSING
DRUG CLASSIFICA CONTRAINDICA SIDE
SM OF INDICATION RESPONSIBILI
NAME TION TION EFFECTS
ACTION TIES
A selective
inhibitor of
fungal
cytochrom
e P450 • Chest
dependent tightnes
enzyme s
lanosterol • Clay-
14-a- • Vaginal 1. Use hygiene
colored
demethyla yest measures to
stools
se. This infections prevent
caused by • Dyspha
enzyme gia reinfection
normally Candida
• Systemic • Tachyca
works to 2. Arrange for
rdia
It is used to convert Candida frequent follow-
infections • Hives,
prevent and lanosterol Hypersensitivity up while you are
Generic itching
treat a variety to • Both to drug. There is taking this drug.
Name: or skin
of fungal and ergosteril, esophage no information
Fluconaz rash
yeast which is al and regarding cross- 3. Health
ole • Swelling
infections. necessary oropharyn hypersensitivity teaching about
for fungal geal between on the the side effects
Trade face,
It belongs to a cell wall candidiasi fluconazole and of the drug.
Name: eyelids,
class of drugs synthesis. s other azole
Diflucan lips,
called azole • Cryptococ antifungal agents. 4. Immediate
antifungals The free tongue, report for rash,
cal
nitrogen meningitis throat, change in stool
atom hands, or urine color,
• UTI by
located on legs, difficulty
Candida
the azole feet or breathing and
• Peritonitis genitals
ring of by increased tears/
fluconazol • Light salivation.
Candida
e bings colored
with a stools
single iron • Stomac
atom h pain
located in
the heme
group of
lanosterol
14-a-
demthylas
e. This
prevents
oxygen
activation
and, as a
result,
inhibits the
demethyla
tiof
lanosterol,
halting the
process of
ergosterol
biosynthes
is.
Methylate
d sterols
are then
found to
accumulat
e in the
fungal
cellular
mebrane,
leading to
an arrest
of fungal
growth.
These
accumulat
ed sterols
negatively
affect the
structure
and
function of
the fungal
cell
plasma
membrane
.
NURSING CARE PLAN
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Risk for Nurse would be 1. Verify doctor’s 1. To check the Nurse was able
Objective: Aspiration able to feed client order amount and time of to feed client
Patient has NGT related to with no aspiration FO needed for the with no
inserted NGT inserted noted after patient. aspiration noted
feeding after the
procedure.
2. Notify client’s 2. To inform the
guardian for OF family and the patient GOAL MET
feeding. about the procedure.
3. Put client in 3. To prevent

semi-fowler’s aspiration and for the
position. good flow of the OF.
4. This process will

4. Assess the ensure that the tube
patency of the line is in the stomach.
by auscultation in
the abdomen
5. To avoid
5. Ensure the unnecessary
drainage port lock leakage.
is enclosed before
feeding
6. Food given to a
6. Give OF as patient who is unable
prescribed by the to eat solid food
doctor and dietitian.
7. To avoid leakage
7. After feeding and optimal tubing for
ensure that the the next FO.
drainage port lock
is enclosed 8. To secure no
aspiration happened
8. Observe the during and after
patient. procedure.
SUBJECTIVE Risk for Goal: A. Independent A. After the effective

DATA: fear/anxiety The patient will interventions: Independent intervention the
The patient only related to be able to open • The nurses interventions: patient was able to
communicates situational and express his engage on • To be able express his feelings
with nurses and crisis on feelings to topics that to express using verbal or non-
his daughter cancer as nurses and his might attract his feelings verbal
through non- evidenced by daughter using patients' using verbal communication to
verbal language. feeling of non-verbal attention. or non- ease his inner
helplessness. communication verbal thoughts on his
with his current communicati situation with a
OBJECTIVE condition to on. comfortable
DATA: ease his environment that
• Jaundice feelings. B. Dependent surrounds him,
BP 90/60 interventions:
HR 89 • Nurses on B. Dependent
RR 16 duty will interventio Thus, the goal
T 36.5 inform other ns: was met.
O2 sat 98% at nurses about • To provide a
room air patient case better and
to be able to comfortable
understand environment
how to handle for the patient
the patient and to be
before doing able to feel
rounds with safe inside
the patient. the facility.

Independent:
Subjective: Imbalance Short term goals: • Explore the To establish a Short term goals:
“Nawawalan na Nutrition less After 30 minutes of patient's daily baseline for the After 30 minutes of
than body effective nursing nutritional state of effective nursing
kong gana nutritional intake
requirements intervention, the the patient and intervention, the
kumain” as stated related to client will be able and food habits preferences. client was able to
by the patient abdominal to participate in participate in his diet
pain and specific care plans to
Objectives: cramping as interventions to • Create a daily To adequately increase dietary
➢ Thin evidence by stimulate weight chart and a monitor the intake, thus the goal
➢ Jaundice loss of appetite/increase daily dietary intake was met.
food and fluid
appetite dietary intake. of the patient
T- 37.2°C chart. Discuss with
secondary to and progress in
BP – 100/70 colon cancer. the patient the weight objectives.
mmHG Long term goals: short term and Long term goals:
RR – 30 bpm After one week of long-term nutrition After one week of
02 sat – 91% effective nursing and weight goals. effective nursing
intervention, the To promote nutrition intervention, the
client will be able and healthy client was able to
to display • Help the patient to food habits, as well gain appetite as
normalization of select appropriate as to boost the manifested by the
laboratory values dietary choices to energy levels of the normalization of
and minimize the increase dietary patient. laboratory values,
signs of fiber and high- Dietary fiber can
malnutrition caloric intake with help reduce stool Thus, the goal was
transit time, thus met.
adequate fluid
promoting
intake regular bowel
movement.
Dependent: Nausea and

vomiting are
• Administer frequently the most
antiemetic on a disabling and
regular schedule psychologically
before or during stressful side
and after effects of
administration of chemotherapy
antineoplastic
agent as To provide a more
appropriate specialized care for
the patient in terms
Collaborative: of nutrition and diet
• Refer the patient to in relation to newly
the dietitian diagnosed colon
cancer
References
Medical News Today. (2023). Stage 4 colon cancer life expectancy: Diagnosis and
decisions. Retrieved from https://www.medicalnewstoday.com/articles/325230
Rawla, P., Sunkara, T., & Barsouk, A. (2019). Epidemiology of colorectal cancer:
incidence, mortality, survival, and risk factors. Przeglad gastroenterologiczny, 14(2), 89–
103. https://doi.org/10.5114/pg.2018.81072
Wilkinson, Julie. “Can You Keep Your Colon Happy and Healthy?” Verywell Health,
Sept. 2022, www.verywellhealth.com/what-is-the-colon-796819.

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Colon Cancer Case Study

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OUR LADY OF FATIMA UNIVERSITY

120 MacArthur Hwy, Valenzuela, 1440 Metro Manila

A CASE STUDY OF COLON CANCER

Submitted to the Nursing Service Department of Quezon City General Hospital as a

The Colorectal Cancer

Clinical Characteristics & Tests

ANATOMY AND PHYSIOLOGY

The transformation of the normal colonic epithelium to a precancerous lesion

LABORATORY AND DIAGNOSTIC PROCEDURES

Arterial Blood Gas

Units Results Normal Indications Interpretations

pH --- 7.460 7.35 - 7.45 High Increase in potential hydrogen

pCO2 mmHg 27.1 35 - 45 Low Decrease in partial pressure of

pO2 mmHg 62.5 80 - 100 Low Decrease in partial pressure of

HCO3 mEq/L 18.8 22 - 26 Low Decrease in bicarbonate level

FE mEq/L -5.0 -2 to +2 Low Decrease in serum iron level

O2Sat % 93.5 90 - 100 --- ---

CBC Units Results Normal Indications Interpretations

WBC x10^3/uL 37.55 3.5 - 9.5 High Increase in white

RBC x10^6/uL 2.85 4.3 - 5.8 Low Decrease in red

Hemoglobin g/L 86 120 -160 Low Decrease in

Hematocrit % 25.8 40 - 50 Low Decrease in

MCV fL 90.5 82 - 100 --- ---

MCH pg 30.2 27 -34 --- ---

MCHC g/L 333 316 - 354 --- ---

Platelet x10^3/uL 142 150 - 400 Low Decrease in platelet

Neutrophils % 95.8 40 - 75 High Increase in

Lymphocytes % 1.9 20 - 50 Low Decrease in

Monocytes % 2.1 3 - 10 Low Decrease in

Eosinophils % 0.1 0.4 - 8 Low Decrease in

Basophils % 0.1 0-2 --- ---

Units Results Normal Indications Interpretations

BUN mmol/L 7.51 2.14 - High Increase in blood urea

Creatinine umol/L 68.63 62 – 106 --- ---

Sodium mmol/L 137.4 135 - 155 --- ---

Potassium mmol/L 3.61 3.4 - 5.3 --- ---

Ionized mmol/L 1.36 1.13 - High Increase in serum

Chloride mmol/L 110.70 98 -106 High Increase in serum

Magnesium mmol/L 0.69 0.66 - --- ---

Procalcitonin ng/mL 5.96 0 - 0.30 High Increase in serum

ALP U/L 302.36 40 - 130 High Increase in serum

Total Bilirubin umol/L 126.44 0 - 21 High Increase in total

Direct Bilirubin umol/L 107.85 0-5 High Increase in direct

Total Protein g/L 46.53 64 - 83 Low Decrease in total

Albumin g/L 15.71 35 - 52 Low Decrease in albumin

Globulin g/L 30.82 --- --- ---

A/G Ratiio g/L 0.51 0.82 - 2 Low Decrease in a/g ratio

Fecal Occult Blood Test Positive

NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

3. Put client in 3. To prevent

4. This process will

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

SUBJECTIVE Risk for Goal: A. Independent A. After the effective

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Dependent: Nausea and

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