Colorectal CA

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Colorectal CA by Mind Map: Colorectal CA

1. Assessment

1.1. Risk factors

1.1.1. Third leading cause of CA death

1.1.2. Age

1.1.2.1. > 40 years

1.1.3. Genetics

1.1.3.1. FH or CRC

1.1.3.2. FH of polyps

1.1.3.2.1. Familial adenomatous polyposis (FAP)

1.1.4. Presence of colorectal polyps

1.1.5. Hx or FH of IBD

1.1.5.1. Crohn's disease

1.1.5.2. Ulcerative colitis

1.1.6. Obesity

1.1.7. Diet

1.1.7.1. Lack of fiber

1.2. S/S

1.2.1. Symptoms are non-specific

1.2.2. GI bleeding

1.2.2.1. Anemia

1.2.3. Recent change in bowel habits or stool characteristics

1.2.3.1. Shapes or sizes

1.2.4. Abdominal or rectal mass

1.3. Laboratory and diagnostics

1.3.1. Colonoscopy or sigmoidoscopy with biopsy

1.3.2. Carcinoembryonic antigen (CEA)

1.3.2.1. Elevated > 5 ng/mL

1.3.3. CBC

1.3.3.1. Iron-deficiency anemia

1.4. Post-surgical assessment

1.4.1. Types of surgeries

1.4.1.1. Colectomy with colostomy or ileostomy

1.4.1.2. Abdominoperineal resection

1.4.2. Ostomies

1.4.2.1. Colostomy

1.4.2.1.1. Stoma

1.4.2.1.2. Peristomal

1.4.2.1.3. Stools

1.4.2.1.4. I&O

1.4.2.2. Ileostomy (Rare)

1.4.2.2.1. Stoma

1.4.2.2.2. Stools

1.4.2.2.3. I&O

1.4.3. Post-rectal excision

1.4.3.1. Damage to pelvic nerves

1.4.3.1.1. Bladder dysfunction

1.4.3.1.2. Erectile dysfunction

2. Intervention

2.1. Colostomy stoma

2.1.1. Document stoma characteristics

2.1.1.1. Reddish Pink and Moist

2.1.2. Report abnormalities

2.1.2.1. Ischemia or necrosis

2.1.2.1.1. Purplish

2.1.2.1.2. Black

2.1.2.2. Mucocutaneous separation

2.1.2.3. Abnormal bleeding

2.1.3. Peristomal

2.1.3.1. Keep clean and dry

2.2. Patient education

2.2.1. Dietary

2.2.1.1. Increase fiber intake

2.2.1.2. Avoid processed meat

2.2.2. Screening

2.2.2.1. Average risk

2.2.2.1.1. Start screening at age 45

2.2.2.1.2. Healthy 45 to 75

2.2.2.1.3. 76 to 85

2.2.2.1.4. > 85

2.2.2.2. High risk

2.2.2.2.1. Screen before age 45

2.2.2.3. Types

2.2.2.3.1. Stool-based test

2.2.2.3.2. Visual exams

2.2.3. Colostomy care

2.2.3.1. Diet

2.2.3.1.1. Avoid gas-producing food and carbonated drinks

2.2.3.2. Skin care

2.2.3.3. Ostomy products

2.2.3.3.1. Apply skin sealant first, then colostomy bag

2.2.3.4. Irrigation if needed (only sigmoid colon)