Gastriccancer胃癌患者的护理查房

Nursing Care of the Patient with Gastric Cancer,Department of Digestive System OncologyHu Yating,Contents,Gastric Cancer-Description,Gastric cancer, also called stomach cancer, is a malignant tumor arising from the lining of the stomach,Gastric cancer cells can spread by breaking away from the original tumor. They enter blood vessels, which branch into all the tissues of the body.,Gastric cancer causes about 800,000 deaths worldwide per year.,Men have more than double the risk of gastric cancer than women.,Gastric Cancer-Causes and Risk Factors,Gastric Cancer,Smoked/salted food,Helicobacter pylori,Family history,Overweight,Smoking and alcohol factors,Precancerous conditions,Gastric Cancer-Symptoms,Abdominal fullness or painDark stoolsDifficulty in swallowingExcessive belchingGeneral decline in health,Loss of appetiteNauseaVomiting, which may contain bloodWeakness or fatigueWeight loss,Gastric Cancer-Diagnosis & Treatment,Laboratory tests1.Complete blood count(CBC) 2.Stool test,X-ray barium meal examination,Gastroscopy,Diagnosis,Gastric Cancer-Diagnosis & Treatment,B ultrasonic,CT Scan,Cytology and pathology examination,Diagnosis,Gastric Cancer-Diagnosis & Treatment,Surgery of stomachChemo therapyRadiation therapyMultimodality therapy,Treatment,Case Management,Cai Chuanyou, male, 69 years oldChief complaint: Gastric cancer with 2 circles of chemotherapy,Case Management,History of present illness:,Abdominal pain without obvious inducement since 4 months agoSevere pain in the right umbilical region, even with back radiationAbdominal distension after eatingStool 1 time /4 days, black stoolNo other symptomsSelf medicationDiagnosis of gastric cardiac adenocarcinoma by gastroscopy biopsySecond cycles of chemotherapy from 2016-01-27 to 2016-01-31,Case Management,Medical history: No special conditionPhysical examination: KPS 80%, general vital signs have no specialAssistant examination: Currently there are none,Nursing Care Plans,Related to worrying about the prognosis and lack of relevant knowledge,Anxiety and fear,Below the body requirement - Related to difficulty in swallowing, disorder of digestion and absorption, etc.,Malnutrition,Stomachache Related to the cancer invasion,Pain,Nursing Care Plans,Related to the protracted course of this disease,Activity intolerance,Related to chemotherapy-induced vomiting,Risk for fluid volume deficit,Gastric bleeding, obstruction, etc.,Potential complication,Nursing Care Plans,Anxiety and fear,More communication and encouragement,Meet the basic needs,Introduce the relevant knowledge,Examples of recover patients,Deep breathing, music therapy, etc.,Anxiety and fear reduced,Nursing Care Plans,Encourage the patient to eatChoose appropriate time to dineMultiple-meal-with-small-amount-for-each,Malnutrition,Nursing Care Plans,Make a reasonable diet(according to the patients eating habits),high heathigh in proteinhigh in vitamin low fateasily digestiblelow-residue,Malnutrition,Nursing Care Plans,Explain the important role of diet on disease recovery,Regular monitoring weight change,Strengthen the parenteral nutrition support, and give the digestive medicine,Malnutrition,No significant changes in body weight,Nursing Care Plans,Pain,Effectively controlled,Nursing Care Plans,Appropriate bed activitiesAssist patients with bedside activitiesFalls preventionRegular massage and maintain normal function,Activity intolerance,Physical strength has been enhanced and no fall occurred,Nursing Care Plans,Risk for fluid volume deficit,Associated with vomiting caused by chemotherapy,Vomiting relieved,Nursing Care Plans,Prevention firstObserve the condition changesIf happened, deal with the complication according to the doctors advice,Potential complication,No complications,Health education,Reasonable diet,Eat small meals and eat slowlyRegular quantitative mealAvoid too cold, too hot, too spicy, fried, salted and smoked foods,Healthy lifestyle,Strike a proper balance between work and restAbstain from alcohol and tobaccoStrengthen self emotional adjustment and keep an optimistic attitude,Health education,Patients undergoing chemotherapy,Pay attention to dietRegular follow-up to check blood routine, blood biochemical, etc.I