Mr. Moore is a 54-year-old man with a past medical history ofhypertension, seasonal allergies, and arthritis. As a young adult,he began smoking in his early 20s and quit when he was 50 yearsold. He lives with his wife of 30 years and they have two grownsons. He is being seen today at a local clinic because he statesthat he has had blood in his stool for 2 months, and he decided itwas time to have it checked out.

1. What further assessment questions should the nurse ask Mr.Moore?

Mr. Moore tells the nurse that he has a frequent sensation of"gas pain" and that he has been growing increasingly tired withinthe past 6 months. Although his job as an attorney requires that hebe seated much of the time, he is finding it difficult to getthrough a normal workday without becoming exhausted. The primarycare provider examines Mr. Moore and orders a series of diagnostictests.

2. What types of diagnostic tests would be appropriate to gathermore information about Mr. Moore's condition?

Mr. Moore's CBC indicates that he is mildly anemic; CEA is 8ng/mL; colonoscopy shows polyps that are suspicious for cancer. ACT scan confirms a mass in the rectum. Mr. Moore is diagnosed withrectal cancer and scheduled for surgery. His surgeon explains thatbecause of the location of the mass, the surgery will leave Mr.Moore with a permanent colostomy.

3. What psychosocial implications of cancer, and of a permanentcolostomy, might Mr. Moore experience?