What are Sandra Li’s risk factors for colon cancer? List each one and describe what pathological changes it may cause.

NR281 Pathophysiology I

Altered Cell Biology Case Study
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Case Study (95 points possible)
Sandra Li is a 45 year old Radiation Therapy technician went to her doctor’s office stating she saw blood
in her stool twice this week and thinks she has hemorrhoids. She also complains of fatigue and 10
weight loss in the last 3 months because she just didn’t feel like eating. Even after the weight loss, she is
still 35 pounds over her ideal weight for her height.

Selected Data Obtained From Nursing Assessment
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She is a second generation Japanese American
Worked for 8 years preparing the radioisotopes for injection during CT scans before she moved
to the Radiation Therapy department.
She was recently diagnosed with type 2 diabetes which is being controlled with oral
medications. She states she understands the need for exercise, both to lose weight and control
her blood sugar. However, she feels too tired after work and admits both she and her husband
are “couch potatoes.” She asked with a grin, “Does playing video games count as playing a
sport?”
Denies smoking, but her husband smokes 2 packs per day
Much to her parents’ dismay, Sandra has adopted a western diet and states she is “addicted to
McDonalds” which she believes is the chief cause of her excess weight. She has also gained
weight since got married. Her husband is a “meat and potatoes guy” who grills steaks or burgers
on the barbeque several times per week no matter the weather.
Analysis of her diet reveals it is high in red meats, high in fat and low in fiber. Both she and her
husband drink at least one beer every evening and usually more on the weekends.
She states she and her husband have been fighting a lot more lately mostly due to financial
burden of modifying their home, which they have lived in for 25 years and was recently
identified a having radon contamination.
Skin warm and dry. Lungs are clear
Vital signs are within normal limits
Lab: Low hemoglobin and hematocrit. Low red blood cell count. Stool sample tested for blood
was positive.

Case Study Questions: Colon Cancer Risk Factor (45 points)
1. What are Sandra Li’s risk factors for colon cancer? List each one and describe what
pathological changes it may cause. (45 points)
NR281 Altered Cell Biology Case Study.pdf

Created 09/ 30/2011 nlh

1

Chamberlain College of Nursing

NR281 Pathophysiology I

The doctor ordered a colonoscopy which indicated colon cancer. The tumor mass was surgically

removed. Cancer cells were found in the adjacent lymph nodes so she was started on
chemotherapy.

Case Study Questions: Cancer Treatment (50 points)
1. What are the chief clinical manifestations of cancer? Describe the pathophysiology that
causes the clinical manifestations. Identify whether Mrs. Li has experienced the
symptom. If not, why might she not have the symptom? (25 points)
2. How does chemotherapy work? Relate the way chemotherapy works to the side effects
of cancer therapy that Mrs. Li may experience. (25 points)

NR281 Altered Cell Biology Case Study.pdf

Created 09/ 30/2011 nlh

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