Question

Alexis Alcorn, 76 year old female with a history of chronic gastritis whose chief complaint was frequent dyspepsia and epigastric pain relieved by antacids. She also complained of rapid weight loss and feeling fatigued. After a series of tests, a biopsy was performed which confirmed gastric cancer. A partial gastrectomy was performed 3 days ago to remove the cancerous lesion. She is also exhibiting signs of depression because of her recent diagnosis.

(BA post gastrectomy)

Questions:

1. What is the pathophysiology of gastric cancer?
2. What is involved in a partial gastrectomy?
3. What are some unique safety concerns related to this patient and her care?
4. What are the components of a basic physical assessment?
5. What body systems should the nurse focus on in the assessment of a post-op day 3 post-gastrectomy patient?
6. What would be normal and abnormal findings for this patient?
7. How do you prioritize assessment findings?
8. What should the nurse do if she/he encounters any abnormal findings?
9. What are the basic and special care needs for a 3-day post-op patient?
10. Describe the difference between serous, serosanguinous, and sanguinous drainage?
11. How do you care for a surgical wound?
12. How do you care for a patient with a nasogastric tube?
13. What strategies would you use as the nurse to assist the patient to cope with a new devastating medical diagnosis?
14. What are the stages of grief?

Answer 1

ANSWERS :

1. PATHOPHYSIOLOGY OF GASTRIC CANCER : Gastric cancers affects anywhere in the stomach, which infiltrates the surrounding mucosal layers of stomach which penetrates the inner walls of stomach and surrounding structures of stomach and organs. Due to this the liver, pancreas, duodenum affects, it leads to metastasis the cancer cells migrate from stomach layers to the to adjacent structures through lymph nodes occurs. Most of the gastric cancers are adenocarcinomas.

2. In partial gastrectomy the surgeon will remove half lower part of stomach near lymph nodes if cancer cells are present to prevent spreading from stomach to adjacent structures. Half part of the stomach is removes in partial gastrectomy.

3. The safety concerns related to the patient is monitoring the condition of patient as she exhibiting signs of depression due to her disease condition, and to be given for the surgical site in the form of sterile dressings, observing for the signs of infections at surgical site, emotional level of patient to be monitored, health checkup of the patient to confirm any development of cancer cells are present or not after surgery, nutritional therapy for quick recovery in a healthier way, psychological support for quick recovery, etc.