Question

How should the nurse interpret the leakage of fecal matter from the vagina of a client with advanced cancer? a. Anal sphincter has been impaired b. Cancer has metastasized to the GI tract c. Rectovaginal fistula has developed d. Rectum is being compressed by the tumor mass

Short answer

c. Rectovaginal fistula has developed

Step-by-step solution

Understand the Situation

A client with advanced cancer is experiencing leakage of fecal matter from the vagina. This abnormal symptom needs to be interpreted accurately to understand the underlying cause.

Analyze Option A

Option A states that the anal sphincter has been impaired. Impairment of the anal sphincter could cause fecal incontinence but does not explain the leakage of fecal matter specifically from the vagina.

Analyze Option B

Option B suggests that the cancer has metastasized to the gastrointestinal (GI) tract. While metastasis can affect various parts of the body, it does not directly cause fecal matter to leak from the vagina.

Analyze Option C

Option C proposes that a rectovaginal fistula has developed. A rectovaginal fistula is an abnormal connection between the rectum and the vagina, which can allow fecal matter to pass from the rectum into the vagina, causing the symptoms described.

Analyze Option D

Option D suggests that the rectum is being compressed by the tumor mass. Compression of the rectum by a tumor could cause bowel obstruction or altered bowel habits but does not explain the leakage of fecal matter into the vagina.

Conclusion

Based on the analysis of the options, the most accurate interpretation is that a rectovaginal fistula has developed.

Key concepts

Understanding Rectovaginal Fistula

A rectovaginal fistula is an abnormal connection between the rectum and the vagina. It can develop as a complication in patients with advanced cancer. This passage allows fecal matter to pass from the rectum into the vagina, causing leakage from the vagina. Rectovaginal fistulas can result from surgical injuries, inflammatory bowel disease, or malignancies. Symptoms often include incontinence of stool or gas through the vagina, recurrent vaginal infections, and irritation. Proper diagnosis and treatment, including surgical repair, are essential to managing this condition effectively.

Cancer Complications

Cancer complications can arise from the tumor itself or as side effects of cancer treatments. For example, tumors in the pelvic region can lead to the development of fistulas, blockages, or compression of nearby organs. These complications can cause symptoms like pain, swelling, and abnormal secretions. Patients with advanced cancer may experience difficulty in managing these complications, requiring multidisciplinary approaches involving oncology, surgery, and palliative care. Close monitoring and prompt treatment are crucial in alleviating symptoms and improving quality of life for these patients.

Nursing Diagnosis

A nursing diagnosis involves assessing and interpreting patient symptoms to determine underlying health issues. In the case of fecal matter leakage from the vagina, a nurse would consider potential causes such as rectovaginal fistula or other gastrointestinal complications. Nursing diagnoses are fundamental in creating effective care plans. They lead to targeted interventions that address the patient's specific needs. Accurate assessment skills and clinical judgment play a vital role in identifying conditions promptly and ensuring appropriate management and treatment.

Symptom Interpretation

Symptom interpretation is critical in healthcare to identify underlying conditions accurately. For advanced cancer patients, unusual symptoms like leakage of fecal matter require thorough evaluation. Nurses must consider multiple factors, including patient history, disease progression, and potential complications. Tools such as patient interviews, physical exams, and diagnostic tests help in understanding the symptoms. Correct interpretation leads to timely and appropriate interventions, which can significantly alter patient outcomes. Continuous learning and experience in clinical practice enhance the ability to interpret symptoms effectively.