Joan Monroy is a 58-year-old public relations consultant who was recently diagnosed with colon cancer after a routine colonoscopy, a procedure in which the colon is examined using a flexible tube attached to an optical device. Mrs. Monroy is scheduled to have surgery to remove the segment of colon that contains the tumor and to determine if the cancer has spread to the surrounding lymph nodes and, possibly, other organs. The nurse completing the nutrition assessment finds that Mrs. Monroy is 5 feet 5 inches tall and weighs 178 pounds. Mrs. Monroy usually spends most of the day sitting and has little time to engage in recreational exercise. Her diet typically includes red meat at both lunch and dinner, and she consumes one or two glasses of wine with both meals. She eats two or three servings of fruits and vegetables each day, although she does not like green leafy vegetables very much. She rarely drinks milk or consumes dairy products.
1. Review Table 23-2 and describe the factors in Mrs. Monroy's diet and lifestyle that may have contributed to the development of colon cancer.
2. What symptoms and complications may arise after colon surgery and impair nutrition status?
3. If the cancer team decides that Mrs. Monroy needs follow-up chemotherapy, how might the chemotherapy affect her nutrition status?
4. If Mrs. Monroy is unresponsive to treatment and her cancer progresses, she may develop cancer cachexia. Describe this syndrome, its causes, and its consequences.
5. Provide suggestions that may help Mrs. Monroy handle the following problems should they develop: poor appetite, fatigue, taste alterations, nausea and vomiting, chewing and swallowing difficulties, mouth sores, dry mouth, diarrhea, constipation, and weight loss.
