Discharge Plan

In preparation for your meeting with John, you are to develop a discharge and self-management plan for discussion with him. Before discussing the plan with John and his family, you are to consider the principles of communication and outline strategies that will facilitate effective education about his discharge and self-management plan.

Mostly, many view it as a death sentence. This disease has resulted to fear in the face of humans. However, there is still a glimmer of hope as the cases of survivors of cancer are on the rise (“World Health Organization,” 2014).  Cancer comprises a group of diseases, among them, is colorectal cancer.

Colorectal type of cancer mainly starts at the colon or the rectum. This cancer typically begins when the cells near the rectum or colons grow out of control. Mostly, colorectal cancer starts as growth on the lining of the rectum or colon known as the polyps. Some type of polyps is likely to change over time (after many years). Usually, the transformation of polyps to cancer will depend on the kind of polyps it is. The two known types of polyps are 1. Adenomatous polyps (adenomas) linked to being a precancerous condition 2. Hyperplastic polyps and inflammatory polyps which is not precancerous (Eberhart et al., 2014). The following document will offer insight on colorectal cancer.

In most instances, there may lack follow up of colorectal Survivors once discharged from health centers. Therefore, a comprehensive plan needs to be recommended to address their needs within the continuum of their care (“Drugs,.com,” 2018). The method should comprise of the following:

1. There should be hotlines for survivors. 911, He/she should call when he/she experience symptoms such as cough blood, experience chest pain, etc.
2. An individual should contact oncologist in case: one has a fever, see blood in bowel movement, cannot control temperature, or in case he/she need support.  
3. Administration of drugs should be done timely, for example, anti-nausea, prescription pain medicine among other-directed.

1. An individual should be encouraged to get screened as directed by a healthcare provider for example yearly, monthly, etc.
2. Colorectal cancer survivors should be warned on various lifestyle activity that affect their health, e.g., smoking
3. .Colorectal survivor should engage in regular exercises as directed by a physician.
4. The Patient should be encouraged to eat healthy food, e.g., fruits. It’s a fact that patient will change their diet in the course of the cancer treatment.

Moreover, Transition care model should be applied to discharged patients. According to this model, it defines a set of activities aimed at the continuation of health care when patient move from a different location, e.g., from hospital to home (Oeffinger and McCabe, 2016). This method entails logistical arrangement, provision of education of patients and family and coordination between health professionals and the discharged patient.

Also, Transition Theory model should be applied to monitor patients. The model defines that a people are likely to undergo a series of change when modifying his/her behavior. The theory recognizes that change occurs over time. A person is expected to undergo the following steps: pre-contemplation( person is not ready), contemplation(person is getting ready), preparation(person is ready) and action  in the course of the therapy. Hence, it’s of great importance to recognize this

Signs and Symptoms

It’s important to note symptoms of Colorectal cancer may not be immediately detected (Adelstein, 2011). However, if discovered the following symptoms will be evident:

1. Changing the habits of the bowel, for example, diarrhea and constipation.
2. There is bleeding of the rectal.

• Stool in blood, which makes the stool look too dark.

1. Pain in the abdominal.
2. Fatigue and general body weakness.
3. Unexpected weight loss.

These symptoms may be coupled with often bleeding of the digestive tract. Eventually, this leads to blood loss whose impact will be low blood cells count condition known as anemia.

It’s the fact that most individuals having colorectal cancer do not have symptoms. Therefore, comprehensive testing and diagnosis need to be conducted. These tests are commonly known as screening tests. In the light, these test helps to prevent or identify colorectal cancer before signs start developing.

During these tests a doctor will be able to gather vital information concerning possible risk factors, medical history of an individual and if necessary individual family history (“World Health Organization,” 2014). The tests are:

Blood count (CBC): This test examines the various cells found in the blood. In case one has low blood count it may indicate an anemic condition (Nordqvist, 2018). Usually, people with the colorectal type of cancer will develop anemia because the bleeding of a tumor has been happening for a long time.

Tumour Markers: Sometimes colorectal cancer develops substances found in the blood which are known as Tumor Markers. Colorectal has two Tumor Markers related to its which are carcinoembryonic antigen (CEA) and CA 19-9 (Ma Y, 2011). Mostly the test on tumor markers may suggest whether one has colorectal cancer, but while administering diagnosis, it cannot be used alone.

Liver enzyme: This is a blood test conducted to check the liver function. It’s significant to carry the analysis as colorectal cancer can spread to the liver.

During this examination, a doctor uses a colonoscopy to check at the colons length. Usually, colonoscopy is a flexible, thin, light tubed device fitted with a camera (Chan, Ogino, and Fuchs, 2009)). This device checks for the presence of polyps.

In this test, in case colorectal cancer is found using colonoscopy (“American Cancer Society,” 2018). A doctor will remove a small piece of the tissue to enable him to give the diagnosis.

In this test, there is the use of a radioactive sugar to test the blood. Mostly cells take in the body take varying amounts of the sugar, and this depends on their growth rate (“American Cancer Society,” 2018). Different from other cells, cancer cells tend to multiply faster (O’Brien et al., 2011). Eventually, the cells will likely take up much amount of sugar than cells which are healthy. The picture of the area with radioactivity is then taken using a particular camera used.

This picture is significant because it will enable a doctor to monitor the cancer spread in different parts of the body. Also, it will help to confirm areas where cancer has spread.

Recommended Testing and Diagnosis

Survivors of colorectal cancers are faced with many issues, for instance, physical, psychological, social, and spiritual which in most cases prove to be a challenge to them.

A research was done indicating that people living with colorectal cancer are more prone to Post-traumatic stress and depression disorder. Mostly the spread of the recession and anxiety was linked to factors such as physical functioning, financial concerns, cognitive function as well as fear of cancer recurrence ( Courneya, 2008). Surprisingly, patients who are married and those who are physically active tend to report a lower level of anxiety. Having these factors in mind doctors should recommend for the screening of survivors with colorectal cancer to determine the likely treatment to be approved.

One of the social issue concerning the colorectal survivors is at work. Indeed, many cancer victim desire to continue working or return to labor soon after the culmination of the primary treatment (Grimmett, 2011). A matter of fact, this will be of the best interest of colorectal survivor and the contemporary society at large. Therefore, research should be done to recognize an individual, structural and interpersonal factor that promote or encourage a return to work. Furthermore, a program should be developed that cover Colorectal survivor aspects of work that incorporate the employer, the employee (the survivor) and other employees.

In another instance, lifestyle has been linked to being one of the issues that have contributed to colorectal cancer among Survivors (Lee, et al., 2012). Activities such as the eating of raw meat, smoking, and reduced physical activity make an individual be at high risk of developing cancer. However, it’s evident that healthy lifestyle can reduce the risk of morbidity and mortality after cancer. Moreover, taking vigorous physical exercises can be safe and effective (McCorkle et al., 2011). Furthermore, research should be conducted to clarify the mechanism and pathways whose change in health behavior that risk the health and health results in the cancer survivor population.

 Even though Cancer treatment end, colorectal survivors usually will experience physical side effects (Jim and Andersen, 2008). The extent to which the side effects last depend on the treatment an individual received. The side effects might be Fatigue, Problems fighting infections, lymphedema, memory loss, altering the sexual function,  problems related to nerves such as tingling and numbness, muscle and bone weakness, secondary cancer as well as anemia (“Bowel Cancer Australia,” 2017) (Nordqvist, 2018). All these side effects are likely to add up to pain (Adelstein, 2011). Pain, in this case, should not be isolated should be a result. In this case, Survivors of Colorectal should work closely with doctors who in turn will provide the needed diagnosis for the treatment.

Education and Self-Management Plan

The spiritual issue has been one of the topics affecting colorectal cancer survivors. Spirituality is considered significant as it helps to cope up with cancer, adjusting to the life after cancer diagnosis and wellbeing of  the survivor (Whitford, 2012). According to a study done by scholarly well-being activities which alter the body of colorectal cancer survivors are likely to change their spiritual well-being (Meneses et al., 2017). These activities may be surgery to the Individuals. In another instance, researchers have indicated that religious factors with positive mental and physical health may reduce mortality among the survivors of colorectal cancer (Puchalski, 2012). Therefore, it’s vital for doctors to include spiritual aspects within the continuum of care for colorectal cancer survivors.

A person living with Coronary cancer should apply Orem’s theory in the course of their life. This theory of great importance because it provides excellent insight into activities that one should perform to maintain a healthy lifestyle. (Petripin, 2016) According to this theory, it comprises a set of actions that an individual does on his/her behalf to maintain wellbeing and health. These activities include; maintenance of sufficient intake of food, water, and air, balancing rest and activities, prevention from risks to healthy life. Furthermore, this theory has the nursing system of care prerequisite to patient classified as follow: partly compensatory, supportive education and wholly compensatory structure.

It’s evident that healthy lifestyle promotes survival. Its therefore of vital importance to provide health education and guidelines to Cancer survivors as this will enable them to cope with life (Grimmett, 2011). In summary, the following are the essential guidelines that will be helpful to cancer survivors:

1. Survivors should engage in the regular physical activity.
2. Colorectal survivors should maintain a healthy weight.

3Colorectal survivors should consume a lot of vegetables and fruits.

1. Survivors should avoid the use of liquor and smoking.
2. Avoid consumption of processed and red meat.

Conclusion

Colorectal survivors are also human who are vital in the significant contribution to the world. Hence, they should be given care and anything that increase their survivability. As has been noted, it’s critical for a colorectal survivor to refrain from activities that are likely to cause recurrence of cancer. Mainly, he/she should check on his/her lifestyle habits that may affect his/her health negatively. Precisely, he/she should avoid consuming a diet that might cause recurrence, e.g., red meat. Moreover, the Colorectal survivor should liaise with a physician during treatment (screening and diagnosis), and in case he /she needs any additional support. By doing all these activities, a colorectal survivor is likely to increase his/her chances of survival.

References

Adelstein BA, M. P. (2011). Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC Gastroenterology, 65.

American Cancer Society. (2018, 05 28). Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/how-diagnosed.html

Bowel Cancer Australia. (2017). Bowel Cancer Australia. Retrieved from Survivorship Care Plan: https://www.bowelcanceraustralia.org

1. Grimmett, J. B. (2011). Lifestyle and quality of life in colorectal cancer survivors. Quality of Life Research, 1237-1245.

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2018, February 9). Centers for Disease Control and Prevention. Retrieved from Colorectal(colon) cancer: http/www.cdc/gov.com

Drugs,.com. (2018, February 28). Retrieved from Colorectal Cancer: https://www.drugs.com

Cappuccino, E. R.-P. (2003). Estimation of fruit and vegetable intake using a two-item dietary questionnaire: a potential tool for primary health care workers. Nutrition, Metabolism and Cardiovascular Disease, 547-561.

K.S. Courneya, P. K. (2008). Physical activity and obesity in Canadian cancer survivors. Cancer, 2475-2482.

Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet, 219-29.

Ma Y, Z. P. (2011). Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies”. Journal of Clinical Oncology, 3775-82.

Nordqvist, C. (2018, January 9). MEDICAL NEWS TODAY. Retrieved from Colorectal cancer: What you need to know: https://www.medicalnewstoday

Whitford HS, O. I. (602-610). The multidimensionality of spiritual wellbeing: peace, meaning, and faith and their association with quality of life and coping in oncology. Psychooncology, 2012.

World Health Organization. (2014). World Health Organization. 2014. ISBN 9283204298.

McCorkle, R., Ercolano, E., Lazenby, M., Schulman?Green, D., Schilling, L. S., Lorig, K., & Wagner, E. H. (2011). Self?management: Enabling and empowering patients living with cancer as a chronic illness. CA: a cancer journal for clinicians, 61(1), 50-62.

Oeffinger, K. C., & McCabe, M. S. (2016). Models for delivering survivorship care. Journal of Clinical Oncology, 24(32), 5117-5124.

Dow Meneses, K., McNees, P., Loerzel, V. W., Su, X., Zhang, Y., & Hassey, L. A. (2017, September). The transition from treatment to survivorship: effects of a psychoeducational intervention on quality of life in breast cancer survivors. In Oncology nursing forum (Vol. 34, No. 5).

Puchalski, C. M. (2012). Spirituality in the cancer trajectory. Annals of Oncology, 23(suppl_3), 49-55.

Jim, H. S., & Andersen, B. L. (2008). Meaning in life mediates the relationship between social and physical functioning and distress in cancer survivors. British Journal of Health Psychology, 12(3), 363-381.

Eberhart, C. E., Coffey, R. J., Radhika, A., Giardiello, F. M., Ferrenbach, S., & Dubois, R. N. (2014). Up-regulation of cyclooxygenase two gene expression in human colorectal adenomas and adenocarcinomas. Gastroenterology, 107(4), 1183-1188.

O’Brien, M. J., Winawer, S. J., Zauber, A. G., Gottlieb, L. S., Sternberg, S. S., Diaz, B., … & Komorowski, R. (2011). The National Polyp Study: patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology, 98(2), 371-379.

Chan, A. T., Ogino, S., & Fuchs, C. S. (2009). Aspirin use and survival after diagnosis of colorectal cancer. Jama, 302(6), 649-658.