Page 1285 - Saunders Comprehensive Review For NCLEX-RN

4. Postoperative care measures and

complications are similar to those for the care of a
client with pancreatitis and the client following
gastric surgery; monitor blood glucose levels for
transient hyperglycemia or hypoglycemia resulting
from surgical manipulation of the pancreas.
XX. Intestinal Tumors
A. Description
1. Intestinal tumors are malignant lesions that develop in
the cells lining the bowel wall or develop as
adenomatous polyps in the colon or rectum.
2. Tumor spread is by direct invasion and through the
lymphatic and circulatory systems.
3. Complications include bowel perforation with
peritonitis, abscess and fistula formation,
hemorrhage, and complete intestinal obstruction.
B. Risk factors for colorectal cancer
1. Age older than 50 years
2. Familial polyposis, family history of colorectal cancer
3. Previous colorectal polyps, history of colorectal cancer
4. History of chronic inflammatory bowel disease
5. History of ovarian or breast, endometrial, and stomach
cancers

C. Assessment

1. Blood in stool (most common manifestation) detected
by fecal occult blood testing, sigmoidoscopy, and
colonoscopy
2. Anorexia, vomiting, and weight loss
3. Anemia
4. Abnormal stools
a. Ascending colon tumor: Diarrhea
b. Descending colon tumor: Constipation
or some diarrhea, or flat, ribbon-like
stool caused by a partial obstruction
c. Rectal tumor: Alternating constipation
and diarrhea
5. Guarding or abdominal distention, abdominal mass
(late sign)
6. Cachexia (late sign)
7. Masses noted on barium enema, colonoscopy, CT scan,
sigmoidoscopy
D. General interventions

1. Monitor for signs of complications, which

include bowel perforation with peritonitis, abscess or

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