MEDICAL AND NURSING NURSING NURSING SURGERY IN DR.

D WITH
COLORECTAL CANCER

ABSTRACT

Colorectal cancer is a disease caused by abnormal cell growth from cells of the large intestine
tissue. The incidence of colorectal cancer at an advanced stage and the incidence of mortality
and morbidity in Indonesia increases every year due to the lack of early detection and lack of
public information about the signs and symptoms of colon cancer. This requires special
attention in its handling and management. The purpose of this study was to describe nursing
care for colorectal cancer in Temanggung District Hospital on July 10, 2018. The method
used was descriptive method that is to systematically describe cases of managed
management. The results of the study were obtained during 3x24 hours of problems resolved
in accordance with the established criteria.

Keywords: colorectal cancer, colon cancer

INTRODUCTION as one of the developed countries with a

high incidence of colorectal cancer. In
Cancer is a common term in society. Think
2004 there were 2,886,800 incidents and
of it as a disease that is difficult to handle
1,711,000 deaths due to cancer. In the
and appear at any time. Because the risk
digestive system, colorectal cancer is the
factors that are multifactorial and
most common and most commonly found
unpredictable are the most feared things
cancer (Tomislav Dragovich, 2015). In
from this disease. The large intestine and
Indonesia alone, colorectal cancer ranks
rectum are part of the digestive system,
third most in 2012 for both sexes. In men,
which is often called the gastro-intestinal
32% of new cases were found with 10% of
(GI) system or digestive system.
deaths, while females were 14% of new
Colorectal cancer is one of the main causes
cases with 7% of deaths (Globocan, 2012).
of cancer death in the world. This cancer
Colorectal cancer is a term used for cancer
persists as the third most common cancer
that starts in the large intestine or rectum.
and the third most common cause of
Like other cancers, colorectal cancer is a
cancer-related death in America (Rick
multifactorial disease with etiologies
Alteri et al, 2014; Victoria Valinluck Lao,
varying from genetic factors, age,
2012; Tomislav Dragovich, 2015). Europe
environmental exposure (including diet), 2018 to do chemotherapy but the doctor
chronic inflammatory conditions in the refused because KU was a bad patient and
digestive tract and others. The growth of a the doctor suggested hospitalization to
non-cancerous mass called a polyp is the improve KU patients. The patient
first stage of the development of colorectal complains of pain in the right abdomen,
cancer. Polyps may develop slowly over the body feels weak and nauseous. The
10-20 years and turn into colorectal patient was operated on 6 months ago, the
cancer. About 96% of colorectal cancer is rectum was removed and the colostomy
cancer of adenocarcinoma (Rick Alteri et was made. And also patients have been
al, 2014; Victoria Valinluck Lao, 2012; treated 1 month ago at the Temanggung
American Cancer Society 2015). Cancer District Hospital with the same complaint.
that has grown into the cell wall can also In the pattern of cognitive perception
penetrate blood vessel epithelial cells obtained results of
which are then carried to the liver and
P: hepatal metastasis
lymph nodes. That way, after metastasis,
cancer cells can spread to various organs Q: like punctured
(American Cancer Society 2015).
R: right abdomen
OBJECTIVES
S: 5
To describe nursing care for colorectal
T: continuous
cancer in Temanggung District Hospital on
July 10 2018. Physical examination obtained poor
general condition, composmentis
RESEARCH METHODS
consciousness, blood pressure 80/40
This study used a retrospective descriptive mmHg, pulse 104x / minute, breathing 18x
research method. Samples were taken from / minute, temperature 36.8°C, round
medical record data at the Medical Record abdomen there is a stoma, intestinal noise
installation in Temanggung District 18x / minute, pain when pressed, and
Hospital, then the data was processed palpation sounds dim. Blood tests obtained
based on the variables studied. hemoglobin yield 9.5 g / dl, hematocrit
29%, leukocytes 21.8 103/ ul, erythrocytes
RESULTS AND DISCUSSION
3.52 106/ ul, platelets 123 fl. USG
48-year-old Ny. Patient came to examination showed suggestive hepatal
Temanggung District Hospital on July 6, nodular type metastasis hepatoma DD.
Diagnosis in this case is acute pain P: hepatal metastasis4T
associated with a biological injury agent.
Q: like a puncture
The nursing plan for 2x24 hours is
R: right abdomen
expected to be an acute pain problem in
the patient resolved by the criteria of the S:
results of the pain scale decreasing to a
: Continuous
scale of 3, the patient appears more
relaxed. The action plan that will be objective data on the patient's facial
carried out is a non-verbal sign, do a expression flat, blood pressure 90/60
comprehensive pain assessment, teach the mmHg, pulse 98x / minute, breathing 20x /
principles of pain management, set a minute, temperature 36.7°C
comfortable position, collaborate on the
Evaluation on the first day of July 10
administration of analgesics.
2018, the patient said pain
Patient implementation on the first day on
P: hepatal metastasis
July 10 2018 obtained subjective data of
the patient said pain Q: like punctured

P: hepatal metastasis R: right abdomen

Q: like punctured S: 5

R: right abdomen T: continuously The

S: 5 patient appears restless and weak, blood

pressure is 80/40 mmHg, pulse 104x /
T: continuous
minute, breathing 18x / minute,
Objective data the patient looked restless temperature 36.8°C .. Acute pain problems
and weak, blood pressure 80/40 mmHg have not been resolved and continue the
The pulse was 104x / minute, breathing intervention with pengka jian pain, pain
was 18x / minute, the temperature was management, and collaboration with
36.8°C. doctors giving analgesics

On the second day of July 11 2018, Evaluation on the second day of July 11
subjective data was obtained from the 2018, the patient said the pain began to
patient saying that there was still pain. decrease
P: hepatal metastasis Acute pain problems in patients with
colorectal cancer haveresults
Q: like a pierced
P: hepatalmetastasis
R: right stomach
Q: like punctured
S: 4
R: right stomach
T: continuously The
S:
patient seems more relaxed , flat facial
expression, blood pressure 90/60 mmHg, : continuous
pulse 98x / minute, breathing 20x / minute,
4Tblood pressure 90/60 mmHg, pulse 98x
temperature 36.7°C. Acute pain problems
/ minute, breathing 20x / minute,
have not been resolved and continue
temperature 36.7°C
intervention with pain assessment, pain
management, collaboration with doctors
giving analgesics.

CONCLUSION

Cancer is a common term in society. Think

of it as a disease that is difficult to handle
and appear at any time. Because the risk
factors that are multifactorial and
unpredictable are the most feared things
from this disease. The large intestine and
rectum are part of the digestive system,
which is often called the gastro-intestinal
(GI) system or digestive system.
Colorectal cancer is one of the main causes
of cancer death in the world. This cancer
persists as the third most common cancer
and the third most common cause of
cancer deaths in America (Rick Alteri et
al, 2014; Victoria Valinluck Lao, 2012;
Tomislav Dragovich, 2015)