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 > 40 years

1.1.3. Genetics FH or CRC FH of polyps Familial adenomatous polyposis (FAP)

1.1.4. Presence of colorectal polyps

1.1.5. Hx or FH of IBD Crohn's disease Ulcerative colitis

1.1.6. Obesity

1.1.7. Diet Lack of fiber

1.2. S/S

1.2.1. Symptoms are non-specific

1.2.2. GI bleeding Anemia

1.2.3. Recent change in bowel habits or stool characteristics 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) Elevated > 5 ng/mL

1.3.3. CBC Iron-deficiency anemia

1.4. Post-surgical assessment

1.4.1. Types of surgeries Colectomy with colostomy or ileostomy Abdominoperineal resection

1.4.2. Ostomies Colostomy Stoma Peristomal Stools I&O Ileostomy (Rare) Stoma Stools I&O

1.4.3. Post-rectal excision Damage to pelvic nerves Bladder dysfunction Erectile dysfunction

2. Intervention

2.1. Colostomy stoma

2.1.1. Document stoma characteristics Reddish Pink and Moist

2.1.2. Report abnormalities Ischemia or necrosis Purplish Black Mucocutaneous separation Abnormal bleeding

2.1.3. Peristomal Keep clean and dry

2.2. Patient education

2.2.1. Dietary Increase fiber intake Avoid processed meat

2.2.2. Screening Average risk Start screening at age 45 Healthy 45 to 75 76 to 85 > 85 High risk Screen before age 45 Types Stool-based test Visual exams

2.2.3. Colostomy care Diet Avoid gas-producing food and carbonated drinks Skin care Ostomy products Apply skin sealant first, then colostomy bag Irrigation if needed (only sigmoid colon)