A client with which of the following conditions may be likely to develop rectal cancer?
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Solution
Adenomatous polyps
A client with adenomatous polyps has a higher risk for developing rectal cancer than others do. Clients with diverticulitis are more likely to develop colon cancer. Hemorrhoids don’t increase the chance of any type of cancer. Clients with peptic ulcer disease have a higher incidence of gastric cancer.
A client with rectal cancer may exhibit which of the following symptoms?
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Solution
Rectal bleeding
Rectal bleeding is a common symptom of rectal cancer. Rectal cancer may be missed because other conditions such as hemorrhoids can cause rectal bleeding. Abdominal fullness may occur with colon cancer, gastric fullness may occur with gastric cancer, and right upper quadrant pain may occur with liver cancer.
Which of the following complications of gastric resection should the nurse teach the client to watch for?
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Solution
Dumping syndrome
Dumping syndrome is a problem that occurs postprandially after gastric resection because ingested food rapidly enters the jejunum without proper mixing and without the normal duodenal digestive processing. Diarrhea, not constipation, may also be a symptom. Gastric or intestinal spasms don’t occur, but antispasmodics may be given to slow gastric emptying.
Care for the postoperative client after gastric resection should focus on which of the following problems?
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Solution
Nutritional needs
After gastric resection, a client may require total parenteral nutrition or jejunostomy tube feedings to maintain adequate nutritional status.
A client with gastric cancer can expect to have surgery for resection. Which of the following should be the nursing management priority for the preoperative client with gastric cancer?
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Solution
Correction of nutritional deficits
Client’s with gastric cancer commonly have nutritional deficits and may be cachectic. Discharge planning before surgery is important, but correcting the nutrition deficit is a higher priority. At present, radiation therapy hasn’t been proven effective for gastric cancer, and teaching about it preoperatively wouldn’t be appropriate. Prevention of DVT also isn’t a high priority to surgery, though it assumes greater importance after surgery.
Which of the following diagnostic tests may be performed to determine if a client has gastric cancer?
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Solution
Gastroscopy
A gastroscopy will allow direct visualization of the tumor. A colonoscopy or a barium enema would help diagnose colon cancer. Serum chemistry levels don’t contribute data useful to the assessment of gastric cancer.
A client with gastric cancer may exhibit which of the following symptoms?
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Solution
Feeling of fullness
The client with gastric cancer may report a feeling of fullness in the stomach, but not enough to cause him to seek medical attention. Abdominal cramping isn’t associated with gastric cancer. Anorexia and weight loss (not increased hunger or weight gain) are common symptoms of gastric cancer.
A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
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Solution
Peritonitis
Bowel spillage could occur during surgery, resulting in peritonitis. Complete or partial bowel obstruction may occur before bowel resection. Diverticulosis doesn’t result from surgery or colon cancer.
Which of the following symptoms is a client with colon cancer most likely to exhibit?
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Solution
A change in bowel habits
The most common complaint of the client with colon cancer is a change in bowel habits. The client may have anorexia, secondary abdominal distention, or weight loss. Fever isn’t associated with colon cancer.
Radiation therapy is used to treat colon cancer before surgery for which of the following reasons?
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Solution
Reducing the size of the tumor
Radiation therapy is used to treat colon cancer before surgery to reduce the size of the tumor, making it easier to be resected. Radiation therapy isn’t curative, can’t eliminate the malignant cells (though it helps define tumor margins), can could slow postoperative healing.