Documente Academic
Documente Profesional
Documente Cultură
MARY'S COLLEGE
NURSING PROGRAM
Tagum City
A CASE STUDY
on
___________________________
Presented to:
In
__________________________
By:
August 2009
TABLE OF CONTENTS
A. Introduction - - - - - - - - -
C. Assessment - - - - - - - - -
• Biographic Data
• Chief Complaint
• History of Present Illness
• Past medical and Nursing History
• Personal, Social-Economic History
D. Patient Need Assessment - - - - - - -
E. General Survey - - - - - - - - -
I. Symptomatology - - - - - - - -
K. Pathophysiology - - - - - - - -
• Written Pathophysiology
• Diagram
L. Synthesis of clients conditioned status from
admission to present - - - - - - - -
O. Bibliography - - - - - - - - -
A. INTRODUCTION
Heart disease is the leading cause of death for all people in the US, and stroke is
the third leading cause of death. Heart disease and stroke are also major causes of
disability and significant contributors to increasing health care costs in the US. The
mortality rate for cardiovascular disease (heart disease, stroke, and chronic obstructive
pulmonary disease) is greater than the combined rate for all leading causes of death
(cancer, unintentional injuries, pneumonia/influenza, diabetes, suicide, kidney disease,
chronic lever disease and cirrhosis). (US DHHS, 2000). The major risk factors for
cardiovascular disease are hypertension, smoking, hypercholesterolemia, high alcohol
consumption, and lack of physical activity. (Tamir and Cachola, 1994). In 2001 there
were approximately 460,000 indigenous people in Australia, accounting for 2.4% of the
population. However persons greater than 40 years old account for proportionately
fewer indigenous people, reflecting the fact that indigenous people are much more likely
to die before they are old than the general Australian public: men at 56 years; women at
63 years. In addition, death rates are estimated to be four times higher in indigenous
than in non-indigenous Australians.
In 2002 the leading cause of death in indigenous people was cardiovascular
disease (CVD), responsible for 1/3 of all deaths, followed by ischemic heart disease
(16%) and stroke (9%). Of indigenous Australians aged 35–44 years, 16% reported a
cardiovascular condition, with the rate increasing to 31% for those aged 45 to 54 years,
and to 47% for those aged 55 years and over. The prevalence of cardiovascular
disease is greater in remote areas. Coronary heart disease is 3–4 times higher for
males and females than in non-indigenous people. Indigenous people are much more
likely to die of CVD than non-indigenous people at any age, especially in younger age
groups – the death rate among 25–54 year olds was 10 times higher than other
Australians.
Every hour, nine Filipinos die of cardiovascular or heart diseases. In fact,
cardiovascular diseases (CVD) remain the No. 1 cause of death in the Philippines.
About one out of four deaths in the country are traced to cardiovascular diseases,
according to the Department of HealthOne out of 20 adults (40 years and older) suffers
from coronary/ischemic heart disease. And one out of 10 adults (15 years and older)
suffers from hypertension, or high blood pressure. Five out of 100 adults suffer from
coronary artery disease. Surveys made by the DOH show that Central Luzon had the
highest cases of cardiovascular diseases (225 per 100,000 population). Metro Manila
registered the highest mortality rate (99 per 100,000) while the lowest was in Central
Mindanao (16 per 100,000).
During the past three years, eight of the ten leading causes of morbidity in Davao
Region were communicable but highly preventable diseases. In 2002, the illnesses
registered were the upper and lower respiratory tract infections, pneumonia, diarrhea,
influenza, tuberculosis, malaria and dengue. The non-communicable leading causes of
morbidity were hypertensive diseases and genitourinary system diseases. In 2002-
2004, cerebrovascular diseases topped the leading causes of mortality, indicating the
need to examine closely the lifestyle of the at-risk population in the region. In 2002,
heart diseases ranked second to cerebrovascular diseases. Other leading causes of
death among all ages include pneumonia, accidents, malignant neoplasms,
tuberculosis, hypertensive diseases, diabetes mellitus, lower respiratory infections and
septicemia.
Cumulative risk and trends in prostate cancer incidence in Mumbai, India.
Information relating to cancer incidence trends in a community forms the scientific basis
for the planning and organization of prevention, diagnosis and treatment of cancer. We
here estimated the cumulative risk and trends in incidence of prostate cancer in
Mumbai, India, using data collected by the Bombay Population-based Cancer Registry
from the year 1986 to 2000. Methods; During the 15 year period, a total of 2864
prostate cancer cases (4.7% of all male cancers and 2.4% of all cancers) were
registered by the Bombay Population-based Cancer Registry. Results; Analysis of the
trends in age-adjusted incidence rates of prostate cancer during the period 1986 to
2000 showed no statistically significant increase or decrease and the rates proved
stable across the various age groups (00-49, 50-69 and 70+) also. The probability
estimates indicated that one out of every 59 men will contract a prostate cancer at some
time in his whole life and 99% of the chance is after he reaches the age of 50.
Department of Urology, National Taiwan University Hospital and National Taiwan
University College of Medicine, Taipei, Taiwan. Although Asian people have the lowest
incidence and mortality rates of prostate cancer in the world, these rates have risen
rapidly in the past two decades in most Asian countries. Prostate cancer has become
one of the leading male cancers in some Asian countries. In 2000, the age-adjusted
incidence was over 10 per 100000 men in Japan, Taiwan, Singapore, Malaysia, the
Philippines and Israel. Although some of the increases may result from enhanced
detection, much of the increased incidence may be associated with westernization of
the lifestyle, with increasing obesity and increased consumption of fat. The differences
in incidences between native Americans and Asian immigrants are getting smaller,
reflecting a possible improvement of diagnostic efforts and changes of environmental
risk factors in Asian immigrants. Nevertheless, the huge variations in incidences among
ethnic groups imply that there are important genetic risk factors. The stage distributions
of prostate cancer in Asian populations are still unfavorable compared to those of
Western developed countries. However, a trend towards diagnosing cancer with more
favorable prognosis is seen in most Asian countries. Both genetic and environmental
risk factors responsible for elevated risks in Asian people are being identified, which
may help to reduce prostate cancer incidence in a chemopreventive setting. The
incidence of prostate cancer has risen by 5-118% in the indexed Asian countries (age-
specific and age-standardized) based on incidence and mortality rates data for prostate
cancer in Asian countries for 1978-1997. Incidence at centers in Japan rose as much as
102% (Miyagi 6.3-12.7 per 100,000 person-years) while the incidence in Singaporean
Chinese increased 118% from 6.6 to 14.4 per 100,000 person-years. The lowest
incidence rate recorded was in Shanghai, China and the highest rates were in Rizal
Province in the Philippines, although still much lower than those in the United States of
America (USA) and many European countries.
Prostate Cancer is the fourth most common male malignancy worldwide.
Incidence and death rates vary tremendously among countries, however in the
Philippines, more and more cases are being seen every year. Local interest in Prostate
Cancer has also been in the spotlight since the last Presidential Elections when
Presidential Candidate Raul Roco revealed that he was diagnosed to have advanced
disease.
In the 1990s, Quijano did a research in Guihing, Davao Del Sur, where he
attributed the high incidence of prostate and breast Cancer and other illness there to the
patients’ prolonged exposure to pesticide in the nearby banana plantations. “Although
other factors — such as malnutrition and the lack of sufficient housing — also
contribute, long pesticide exposure was largely to blame for those diseases,” he said,
citing similar symptoms among people living near banana and pineapple plantations in
South Cotabato and different parts of Davao city.
According to Local Studies Related to Aerial Spraying regarding Health and
Environmental Conditions of People Living in Three Communities of Davao City Where
Aerial Spraying of Pesticides is a Common Practice. September 2006. Of the 22 cases
of cancer: 6 cases (27.3%) –prostate cancer, 4 cases (18.2%) – breast cancer, 2 cases
each (9.1%) – brain, uterine, bone cancer, 1case each (4.5%) – liver, colon, leukemia,
throat, thyroid, lung cancer.
B. OBJECTIVES
General:
After apprehensive case study, students will be able to extend and improve their
knowledge and understanding with regards to the causes, effects, complications, signs
and symptoms and nursing implementation for Hypertensive Urgency, HCVD, CAD,
LVH, SR, NIF; Prostate CA Stage III for them to be able to attain a comprehensive and
thorough learning experience with regards to their study that would benefit not only
them but also for their readers and for the patients that they will be catering in the future
with such kind of disease.
Specific:
• Study the patient’s history of past and present illness
• Conduct a synoptic physical assessment of patients with Hypertensive Urgency,
HCVD, CAD, LVH, SR, NIF; Prostate CA Stage III
• Be able to review the anatomy and physiology of the affected organs and
systems
• Distinguish the affected system
• Trace and analyze the pathophysiology of the infirmity
• Classify the ordered drugs and associate its action or effects to the patient
• Consider laboratory results and relate it to patient’s condition
• Construct nursing care plan for patients with Hypertensive Urgency, HCVD, CAD,
LVH, SR, NIF; Prostate CA Stage III
• Identify prognosis of the patient
• Evaluate the client’s condition from the time of admission up to the present
C. ASSESSMENT
A. Biographical Data
Name: Megatron
Age: 78 years old
Gender: Male
Civil Status: Married
Birthdate: November 11, 1930
Birth Place: Dumangas, Iloilo
Nationality: Filipino
Religion: Protestant
Occupation: Pastor
Name of Spouse: Starscream
Admitting Diagnosis: Hypertensive Urgency, HCVD, CAD, LVH, SR, NIF; Prostate CA
Stage III
Admitting Physician: Precy Gem T, Sanchez, M.D.
B. Chief Complaint
Admitted due to dizziness, inability to walk and loss of appetite
VS upon admission:
T – 37.3oC PR – 89 bpm
RR – 32 cpm BP – 170/110 mmhg
Weight – 77 kgs. Height: 5 feet 4inches
F. Socio-Economic History
Megatron belongs to middle class family. For 15 years of being a farmer way
back 1964-1979, he earned P50.00 – P100.00 monthly as usual income. Immediately
after being a farmer, he became then a pastor and receives an honorarium monthly of
about P2,000-3,000 monthly. Her wife is a plain housewife while most of his children
now has stable job.
PHYSIOLOGIC NEEDS
I. OXYGENATION
BP__140/80__ RR 25 cpm____CR___88bpm
(CHARACTER) tachypneic___
LUNGS (per auscultation: character, lung sound, symmetry of chest expansion,
breathing character and pattern):crackles sounds heard upon auscultation, w/
symmetrical chest expansion, intercostals retraction noted, use of accessory
muscles noted.
CARDIAC STATUS (per auscultation) sounds, character, chest pain.
__”Lub-dubb” sound heard with increased intensity per auscultation, chest pain
not noted
• CAPILLARY REFILL good capillary refill of less than 3
seconds_
• SKIN CHARACTER AND COLOR_skin is brown, dry, flaky
and wrinkled.
• LIFE SUPPORTING APPARATUS: with O2 @ 3LPM via
nasal cannula
• OTHER OBSERVATIONS (related) Patient shows
discomfort with the nasal cannula by removing it.
II. TEMPERATURE MAINTENANCE
TEMPERATURE: 37.2 oC_
GRAVIDA/PARITY__N/A__ PRENATAL__N/A__
EDC__N/A__
FMILY PLANNING METHOD USE: calendar method
CHILDREN (no.) __9__ MENARCHE__N/A__
VIII STIMULATION ACTIVITY
WORK: Before: farmer & pastor During: needs assistance in performing activities of
RECREATION/PAST TIME: daily living, can’t able to sit, episodes of napping &
HOBBIES/VICES: sleeping, a moderate smoker and drinker before
SAFETY AND SECURITY
NEURO VS____GCS of 10/15, eye opening – to verbal command, motor response –to
localized pain, and verbal response – makes incomprehensible sounds _____
MENTAL STATUS (Coherent, Responsive, conscious, unconscious) conscious, able to
respond by making incomprehensible sounds
EMOTIONAL PROBLEM (diaphoretic, trembling, restless)_restlessness: frequent
change of position due to pain felt________
LOVE BELONGING NEED
CHILDREN (living with?) Patient is loving and supportive as verbalized by her child and
HUSBAND (living with) wife. Due respect and care was given to him
SELF ESTEEM NEED
He is a good person and a loving father, husband and pastor. He has a moderate self
esteem, also because he is a friendly type of person and being loved by family members.
Assessed by:
______A4_________ __Evie Luz Docena, RN, MN__
SN-SMC CI
E. GENERAL SURVEY
Date of Assessment: July 30, 2009
On bed, awake, unresponsive and tachypneic. With isocoric pupils of 2mm less
briskly reactive to light and accommodation. Pale conjunctiva of the eye noted. With O2
@ 3LPM via nasal cannula, with NGT @ Right nostril patent and intact, with distal end
close. (+) use of accessory muscles; (+) intercostal retraction; crackles sound heard per
auscultation on both lung fields. With symmetrical chest expansion. With IVF of # 5
PNSS 1L @ 300cc/hr @ 200 cc level infusing well @ Left metacarpal vein. Pale
nailbeds noted with capillary refill returns within 3 seconds. Bladder distention noted.
With FBC attached to urobag draining a bloody urine @ 100 cc level. Bipedal edema
noted.
B. Vital Signs upon admission and present
VITAL SIGNS
C. Nutritional Status
Megatron stands 5”4’ and weighs 77 kilos. On low salt, low fat diet. With NGT at
Right nostril patent and intact, with distal end close. On osteorized feeding of 1.8
kcal/day. With IVF of #5 PNSS 1L @ 300cc/hr infusing well at Left metacarpal vein.
With poor skin turgor. Denies malnutrition during childhood. Weight loss noted from 85
kg to 77 kg.
D. Neurologic Status
Glasgow Coma Scale of 10/15; eye opening – to verbal command, motor
response – to localized pain & verbal – makes incomprehensible sounds, unclear.
Restlessness: frequent change of position noted. Can’t able to speak out clearly to
express feelings and ideas.
E. Integumentary System
Skin is dry, flaky and wrinkled. Flat tan to brown-colored macules noted as large
as 1-2 cm on exposed body area such as face, neck, arms, hands and legs. Skin loses
its elasticity, appears thin and translucent. The skin takes longer to return to its natural
shape after being tented between the thumb and finger.
Hair is gray in color, thin and loss of scalp noted. Presence of parasites not noted.
Bristle-like hairs of the eyebrows noted.
Fingernails slightly long in length, pale and thick. Capillary refill returns within 3
seconds.
F. HEEN
Head is symmetrically rounded. Dry lips noted. Neck symmetrical without masses
and scars. Lymph nodes non palpable.
Eyes. Eyeballs appear sunken. Skin folds of the upper lids is more prominent &
lower lids sag. The eyes appear dry and lusterless. A thin, grayish white arc or ring
appears around the part of the cornea. Pupil reaction to light and accommodation is
normally symmetrically equal but less brisk. Pale conjunctiva of the eyes noted. Visual
acuity is decrease.
Ears of equal size and similar appearance noted. Pinna aligned with corner of
eye, smooth without nodules. Bilateral on auditory canals noted. Contain moderate
amount of waxy secretion. Difficulty of hearing sounds noted.
Nose is symmetrical & straight, uniform in color, non-tender & without lesions.
The sense of smell markedly diminish.
G. Pulmonary System
Respiratory rate is above normal range, with an RR of 32 cpm. Shortness of
breath & dyspnea as well as use of accessory muscles upon breathing is observed,
crackles sounds heard per auscultation on both lung fields. Use of intercostals retraction
upon breathing. With O2 @ 3LPM via nasal cannula.
H. Cardiovascular System
Cardiac rate plays around 80-90 bpm. “Lubb-dubb” sound heard with increased
intensity per auscultation. Chest pain not noted. The anteroposterior diameter of the
chest widens, with symmetrical chest expansion.
Blood pressure dramatically changes from the lowest taken BP of 140/80 & the
highest was 150/100mmHg. Clubbing of fingers not noted. Pallor is observed.
Has history of hypertension.
I. Gastrointestinal System
Abdomen is round. Enlarged border on Right side of abdomen noted upon
palpation as well as distention of bladder. With surgical scar noted on left iliac region.
Bowel movements usually experienced 1-2 times a day with soft and brown color
stool on small amount as described by watcher. Denies presence of hemorrhoids.
J. Musculoskeletal System
Needs assistance in performing activities of daily living. Progressive lower
extremity weakness noted after the patient complained of lumbosacral pain. Presence
of bipedal edema noted.
K. Genito-Urinary System
No bulging or masses that can be palpated in inguinal area. Scanty amount of
pubic hair noted. With FBC attached to urobag draining a bloody urine @ 100 cc level
within the shift. Prior to the insertion of the foley catheter, watcher verbalized that client
has scanty amount of urine about 30-50cc of urine per urination with the absence of
blood and bloody urine was noticed after the insertion of the foley catheter. Urinary
elimination normally once a day. Bladder is distended. Unable to verbalize pain upon
urination. No presence of lesions in the genital area.
F. COURSE IN THE WARD
DATE SHIFT NURSE’S NOTES DOCTOR’S ORDER
07/28/ 311 Admitted this 78 years old Admit under reverse
09 8:00p male patient awake, isolation ward under
m conscious, and coherent in onco/cardio
due to increase BP and body v/s q4
weakness, vital signs taken Labs: CBC, pH, BT,
and recorded. Seen and U/A, ECG
examined by Dr. Sanchez 12 leads, Serum
with new orders made, elec.,
started with IVF of D5NSS 1L Creatinine, RBS,
@ 120cc/o regulated and CXR-PA, PSA
infusing well, lab exams Start IVF with D5NSS 1L @
requested, ECG and CXN 120cc/hr
done. Watched out for signs Meds:
of unusualities, endorsed to
• Captopril 50g
NOD.
now q6hrs if BP >
140/90
• Amlodipine 10g
1tab now OD
6am
• Metoprolol 100g
1tab BID PO
• Atorvastatin 80g
1tab OD @ HS
• Moriamin S2 1tab
TID
Refer for persistent
elevated BP
LSLF diet
Refer accordingly
RBS
7-29-09
TIME RESULT MED GIVEN REFERRED
2:30pm 27mmol 10units IVTT HR Dr. Edgar
given
10:30pm 32.7 HR 15units IVTT Dr. Espina
2:00pm 470mg/dl HR 2units IVTT Dr. Edar
5:00pm 30.1mmol/l
11:00pm 33.3
7-30-09
TIME RESULT MED GIVEN REFERRED
5:00pm 21.5 10units HR Dr. Edar
7:00pm 310.9 8units HR cSS
9:00pm 13.8 4units HR cSS
11:00pm 286 6units HR cSS
2:00pm 26.2
10:00am 32.7
HEMATOLOGY
7-28-09
EXAM NAME RESULT NORMAL INTEPRETATION ANALYSIS
VALUE
Hemoglobin 116 M: 140- Decreased Blood loss,
Mass 170g/L hemolytic anemia,
Concentration F: 120- bone marrow
140g/L suppression, sickle
cell anemia
7-30-09
EXAM NAME RESULT NORMAL INTEPRETATION ANALYSIS
VALUE
Hemoglobin 87 M: 140- Decreased Blood loss,
Mass 170g/L hemolytic anemia,
Concentration F: 120- bone marrow
140g/L suppression, sickle
cell anemia
Leukocyte No. Increased Acute infection,
Concentration circulatory disease,
5,0-
14.1 hemorrhage,
10,0x109/L
trauma, malignant
disease
Neutrophils 0,79 0,55-0,65 Increased Stress and acute
infection
Eosinophils 0,01 0,02-0,04 Decreased Associated with
congestive heart
failure, infectious
mononucleosis, and
aplastic and
pernicious anemia
Lymphocytes 0,20 0,25-0,35 Decreased Adrenal
corticosteroids and
other
immunosuppressive
drugs, autoimmune
diseases
Erythrocyte Decreased iron deficiency
M: 0,40-0,50
Volume 0,25 anemia
F: 0,37-0,43
Fraction
ELECTROLYTES
7-30-09
EXAM NAME RESULT NORMAL VALUE INTEPRETATION ANALYSIS
Creatinine M: 53.3- Increased Associated
115.0umol/L primarily with
F: 44.0- renal disease
240.2
96.0umol/L and obstructive
urinary tract
disease.
Sodium 156.6 135-148mmol/L Increased Hypernatremia
Potassium 3.25 3.5-5.0mmol/L Decreased Hypokalemia
Calcium 1.27 1.13-1.32mmol/L Normal
URINALYSIS
RESULT
Color Light yellow
Transparency Clear
pH 5.0
SG 10.20
Pus cells 0-2
Epithelial cells occasional
ULTRASOUND
Name: Megatron Age: 78 years old
Address: Sto. Tomas, Dvo del Norte Date: 07-30-09
File No.: 09-1382 Department: Medicine
Exam: Abdomen and prostate Service of: Dr. Cuarte
CARDIOVASCULAR SYSTEM
A. Heart Chambers
The heart has four chambers, two atria and two ventricles. The atria are smaller
with thin walls, while the ventricles are larger and much stronger.
Atrium
There are two atria on either side of the heart. On the right side is the atrium that
contains blood which is poor in oxygen. The left atrium contains blood which has been
oxygenated and is ready to be sent to the body. The right atrium receives de-
oxygenated blood from the superior vena cava and inferior vena cava. The left atrium
receives oxygenated blood from the left and right pulmonary veins.
Ventricles
The ventricle is a heart chamber which collects blood from an atrium and pumps
it out of the heart. There are two ventricles: the right ventricle pumps blood into the
pulmonary circulation for the lungs, and the left ventricle pumps blood into the systemic
circulation for the rest of the body. Ventricles have thicker walls than the atria, and thus
can create the higher blood pressure. Comparing the left and right ventricle, the left
ventricle has thicker walls because it needs to pump blood to the whole body. This
leads to the common misconception that the heart lies on the left side of the body.
Septum
The interventricular septum (ventricular septum, or during development septum
inferius) is the thick wall separating the lower chambers (the ventricles) of the heart from
one another. The ventricular septum is directed backward and to the right, and is curved
toward the right ventricle. The greater portion of it is thick and muscular and constitutes
the muscular ventricular septum. Its upper and posterior part, which separates the aortic
vestibule from the lower part of the right atrium and upper part of the right ventricle, is
thin and fibrous, and is termed the membranous ventricular septum.
B. Coronary Artery
The coronary circulation consists of the blood
vessels that supply blood to, and remove blood
from, the heart muscle itself. Although blood fills
the chambers of the heart, the muscle tissue of
the heart, or myocardium, is so thick that it
requires coronary blood vessels to deliver blood
deep into the myocardium. The vessels that
supply blood high in oxygen to the myocardium
are known as coronary arteries. The vessels that
remove the deoxygenated blood from the heart
muscle are known as cardiac veins. The coronary arteries that run on the surface of the
heart are called epicardial coronary arteries. These arteries, when healthy, are capable
of auto regulation to maintain coronary blood flow at levels appropriate to the needs of
the heart muscle. These relatively narrow vessels are commonly affected by
atherosclerosis and can become blocked, causing angina or a heart attack. The
coronary arteries are classified as "end circulation", since they represent the only
source of blood supply to the myocardium: there is very little redundant blood supply,
which is why blockage of these vessels can be so critical. In general there are two main
coronary arteries, the left and right. • Right coronary artery. Left coronary artery Both of
these arteries originate from the beginning (root) of the aorta, immediately above the
aortic valve. As discussed below, the left coronary artery originates from the left aortic
sinus, while the right coronary artery originates from the right aortic sinus.
PROSTATE GLAND
The prostate is one of the male sex glands. The other major sex glands are the
testicles and seminal vesicles. Together these glands secrete the fluids that make up
semen.
The normal prostate is about the size of a walnut. It lies just below the bladder
and surrounds the beginning of the urethra. The urethra is the tube that runs through
the penis. It carries urine from the bladder and semen from the sex glands.
As the prostate is a sex gland, its growth is influenced by male sex hormones.
The chief male hormone is testosterone, which is produced mostly by the testicles.
Surrounds the urethra just Stores and secretes a clear, slightly alkaline fluid
Prostate gland below the urinary bladder and constituting up to one-third of the volume of
can be felt during a rectal exam. semen. Raise vaginal pH.(25-30% of semen)
Pouch of skin and muscle that Regulates temperature at slightly below body
Scrotum
holds testicles. temperature.
Muscular tubes connecting the During ejaculation the smooth muscle in the vas
left and right epididymis to the deferens wall contracts, propelling sperm
Vas deferens ejaculatory ducts to move forward. Sperm are transferred from the vas
sperm. Each tube is about 30 deferens into the urethra, collecting fluids from
cm long. accessory sex glands en route
I. SYMPTOMATOLOGY
Prostate Cancer
ACTUAL
CLINICAL MANIFESTATION IMPLICATION
SYMPTOMS
• Difficulty starting
urination
Due to the presence of
• Interrupted flow of urine tumor in the prostate
gland
• Difficulty in having an
erection
• Painful ejaculation
• Pain when passing
urine
• Feeling that your
bladder is not emptying
completely when you
urinate
• Nocturia
Painful urination due to
narrowing, obstruction
• Dysuria
and trauma to the
passageway of the urine.
The presence of red
• Hematuria blood cells (erythrocytes)
in the urine due to tumor.
ACTUAL
CLINICAL MANIFESTATION IMPLICATION
SYMPTOMS
• Profuse sweating
• Restlessness Inability to relax or calm
oneself due to improper
oxygenation.
• Cold and clammy skin
• Shortness of breath Breathing difficulty in due
to compensatory
mechanism of the body.
• Dizziness Impairment in spatial
perception and stability
due to poor oxygenation.
• Nausea
• Vomiting
• A loss of consciousness
• Abnormal heartbeat
• Angina
• Heart murmur
• Heart attack
ACTUAL
CLINICAL MANIFESTATION IMPLICATION
SYMPTOMS
• Chest pain
• Confusion
• Irregular heartbeat
• Weakness Inability to exert force
with one's muscles to the
degree that would be
expected given the
individual's general
physical fitness due to
poor oxygenation in the
body.
Impairment in spatial
• Dizziness perception and stability
due to poor oxygenation.
• Nausea
Physical and/or mental
exhaustion that can be
triggered by stress,
• Fatigue medication, overwork, or
mental and physical
illness or disease such as
Hypertension.
Breathing difficulty in due
• Shortness of breath to compensatory
mechanism of the body.
• Nausea
• Anxiety
• Nose bleeds
• Vomiting
• Heart palpitations
ACTUAL
CLINICAL MANIFESTATION IMPLICATION
SYMPTOMS
• Chest pain
• Palpitations
Impairment in spatial
• Dizziness perception and stability
due to poor oxygenation.
• Fainting
Breathing difficulty in due
• Dyspnea to compensatory
mechanism of the body.
• Angina
• Abdominal discomfort
Abnormal accumulation
of fluid beneath the skin,
• Swelling (edema)
or in one or more cavities
of the body.
J. ETIOLOGY
Prostate Cancer
The exact cause of Prostate Cancer is unknown. What is known, however, is that
Prostate Cancer, like other cancers, is an uncontrolled growth of abnormal cells, and
that the growth of Prostate Cancer is related to the male hormones, called androgens,
the most prevalent being testosterone. These abnormal cells can form a malignant
(cancerous) tumor. In some cases, the cancer can spread (metastasize) to other organs
of the body. This occurs when cancer cells break away from a cancerous tumor and
move through the blood and lymph nodes to other areas of the body.
While the exact reasons why one man gets Prostate Cancer and another man
does not are unknown. There are risk factors that have been associated with the
incidence of Prostate Cancer in certain populations:
• The incidence of Prostate Cancer increases with age more rapidly than any other
cancer. More than 75% of all cases of Prostate Cancer are in men over 65 years
of age. The average age of men newly diagnosed with Prostate Cancer is 70.
• The risk of Prostate Cancer is twice as high for men of African descent as it is for
Caucasian men.
• Family history: a man is more likely to develop Prostate Cancer if he has first-
generation relatives (such as father or brother) who have been diagnosed with
Prostate Cancer.
Early Prostate Cancer is often asymptomatic. That is, there are no symptoms
caused by the cancer. However, more advanced Prostate Cancer can cause symptoms
including urination problems: a more frequent need to urinate, especially at night;
difficulty starting or stopping urination, blood in urine or ejaculate, and painful urination
or ejaculation. It’s important to note that these symptoms are not limited to Prostate
Cancer, and may be indicative of another, non-cancerous, condition, such as an
infection. If you experience any of the above symptoms, call your doctor.
(http://www.suite101.com/lesson.cfm/17126/1004/2)
The specific causes of prostate cancer remain unknown. A man's risk of
developing prostate cancer is related to his age, genetics, race, diet, lifestyle,
medications, and other factors. The primary risk factor is age. Prostate cancer is
uncommon in men less than 45, but becomes more common with advancing age. The
average age at the time of diagnosis is 70. However, many men never know they have
prostate cancer. Autopsy studies of Chinese, German, Israeli, Jamaican, Swedish, and
Ugandan men who died of other causes have found prostate cancer in thirty percent of
men in their 50s, and in eighty percent of men in their 70s. In the year 2005 in the
United States, there were an estimated 230,000 new cases of prostate cancer and
30,000 deaths due to prostate cancer.
Dietary amounts of certain foods, vitamins, and minerals can contribute to
prostate cancer risk. Men with higher serum levels of the short-chain ω-6 fatty acid
linoleic acid have higher rates of prostate cancer. However, the same series of studies
showed that men with elevated levels of long-chain ω-3 (EPA and DHA) had lowered
incidence. A long-term study reports that "blood levels of trans fatty acids, in particular
trans fats resulting from the hydrogenation of vegetable oils, are associated with an
increased prostate cancer risk." Other dietary factors that may increase prostate cancer
risk include low intake of vitamin E (Vitamin E is found in green, leafy vegetables),
omega-3 fatty acids (found in fatty fishes like salmon), and the mineral selenium. A
study in 2007 cast doubt on the effectiveness of lycopene (found in tomatoes) in
reducing the risk of prostate cancer. Lower blood levels of vitamin D also may increase
the risk of developing prostate cancer. This may be linked to lower exposure to
ultraviolet (UV) light, since UV light exposure can increase vitamin D in the body.
There are also some links between prostate cancer and medications, medical
procedures, and medical conditions. Daily use of anti-inflammatory medicines such as
aspirin, ibuprofen, or naproxen may decrease prostate cancer risk. Use of the
cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk.
More frequent ejaculation also may decrease a man's risk of prostate cancer. One study
showed that men who ejaculated five times a week in their 20s had a decreased rate of
prostate cancer, though others have shown no benefit. Infection or inflammation of the
prostate (prostatitis) may increase the chance for prostate cancer. In particular, infection
with the sexually transmitted infections chlamydia, gonorrhea, or syphilis seems to
increase risk. Finally, obesity and elevated blood levels of testosterone may increase
the risk for prostate cancer.
Prostate cancer risk can be decreased by modifying known risk factors for
prostate cancer, such as decreasing intake of animal fat.
(http://our-medical-center.blogspot.com/2007/12/prostate-cancer.html)
Internet
1. Source: Asian Pacific Journal of Cancer Prevention: Apjcp. 5(4):401-5, 2004 Oct-
Dec.
2. Changing trends of prostate cancer in Asia. Source: Aging Male. 7(2):120-32,
2004 Jun.
3. http://www.prostateline.com/prostate-cancer/anatomy-and-physiology?
itemId=2617452&nav=yes.
4. http://davaotoday.com/2006/04/24/in-many-davao-villages-poison-pours-from-
the-sky/.
5. http://www.dirtybananas.org/pdf/local_studies_on_aerial_spraying.pdf
6. http://www.cancerline.com/2682687/2682690/2682696/2746539/
7. http://www.texasheartinstitute.org/HIC/Anatomy/anatomy2.cfm
8. http://74.125.153.132/search?
q=cache:3MIOUR5r0KAJ:www.dlshsi.edu.ph/forms/research/Regional/Mindanao/
Region11-Agenda.pdf+incidence+report+of+cardiovascular+disease+in+Tagum,
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9. http://our-medical-center.blogspot.com/2007/12/prostate-cancer.html)
10. (http://www.suite101.com/lesson.cfm/17126/1004/2)
11. (http://our-medical-center.blogspot.com/2007/12/prostate-cancer.html)