University of San Jose Recoletos College of Nursing

Worksheet No. 1 NCM 106 lec

Name of Student: DOGUILES, Neil Elmo C. Block: 2

Gastric Cancer A. Predisposing Factors Helicobacter pylori infection Stomach lymphoma Gender Aging Ethnicity Geography Diet Tobacco use Obesity Previous stomach surgery Pernicious anemia Type A blood Inherited cancer syndromes A family history of stomach cancer

 Some types of stomach polyps Epstein-Barr virus infection Certain occupations B. Assessment (Signs and Symptoms) Fatigue Anorexia and Weight loss Nausea and Vomiting Indigestion and epigastric discomfort A sensation of pressure in the stomach Dysphagia Anemia Ascites Palpable mass C. Surgical Management The only successful treatment of gastric cancer is gastric resection, surgical removal of part of the stomach with involved lymph nodes; postoperative staging is done and further treatment may be necessary. Surgical options include proximal or distal subtotal gastric resection; total gastrectomy (includes adjacent organs such as tail of pancreas, portion of liver, duodenum); or palliative surgery such as subtotal gastrectomy with gastroenterostomy to maintain continuity of the GI tract. Surgery may be combined with chemotherapy to provide palliation and prolong life.
D. Nursing Management Pre-operatively

Monitor vital signs

 Monitor hemoglobin and hematocrit and administer blood transfusion as prescribed Monitor weight Assess nutritional status; encourage small, bland, easily digestible meals with vitamin and mineral supplements Administer pain medications as prescribed Prepare the client for chemotherapy or radiation therapy as prescribed Prepare the client for surgical resection of the tumor as prescribed E. Nursing Management Post-operatively Monitor vital signs Place in fowlers position for comfort Monitor I & O; administer fluids and electrolyte replacement by IV as prescribed Maintain NPO status as prescribed for 1 to 3 days until peristalsis returns Monitor nasogastric (NG) suction
Do not irrigate or remove the NG tube; assist the physician with

irrigation or removal Assess bowel sounds Advance the diet from NPO to sips of clear water to six small bland meals a day, as prescribed Monitor for complications of hemorrhage, dumping syndrome, diarrhea, hypoglycemia, and vitamin B12 deficiency F. Learning Insights Its so hard to live having cancer. The thought of being subjected to those signs and symptoms, invasive treatments and having to deal with the span of life you have. That is why, as biological beings, we must be

conscious with the way of life and go through what makes us happy and healthy and avoid things that could extinguish our lives in an early age. G. Reference/Source http://www.cancer.org/Cancer/StomachCancer/DetailedGuide/stomachcancer-risk-factors