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.

Case Study

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.

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Selected Data Obtained From Nursing Assessment

• 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

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