Unit 34 Care of the client with Gastric Carcinoma Fujian Health College Surgical Nursing Department

What is Gastric Carcinoma? Gastric Cancer A malignant growth in the stomach. Risk Factors: diet high in complex carbohydrates, grains and salt, low in in fresh, green leafy vegetables and fresh fruits, smoking, alcohol ingestion, use of nitrates and history of gastric ulcers. Complications: hemorrhage, obstruction, metastasis and dumping syndrome Goal of treatment: To remove the tumor and provide nutritional program.

Signs and Symptoms Fatigue Anorexia and weight loss Nausea and vomiting Indigestion and epigastric discomfort A sensation of pressure in the stomach Difficulty of swallowing (dysphagia) Anemia Ascites Palpable mass

Nursing care for patient with Gastric carcinoma Monitor vital signs. Monitor hemoglobin and hematocrit and administer blood transfusion as prescribed. Monitor weight. Assess nutritional status, encourage small, bland, easy digestible meals with vitamins and mineral supplements. Administer pain medication as prescribed. Prepare the patient for chemotherapy or radiation therapy as prescribed. Prepare for possible surgical removal of the tumor.

Post- operative Nursing care Monitor vital signs. Place in Fowler’s position (90 degrees) for comfort. Monitor intake and output, administer fluids and electrolyte replacement by IV as prescribed. Maintain NPO status as prescribed for 1 to 3 days until peristalsis returns. Monitor nasogastric suction. Do not irrigate or remove the nasogastric tube (NGT).

Post-operative Nursing care Assess for bowel sounds. Advance diet from NPO to sips of clear water to six small bland meals a day, as prescribed. Monitor for monitor complications of hemorrhage, dumping syndrome, diarrhea, hypoglycemia ( low blood sugar) and vitamin B12 deficiency.