Rak żołądka
Charakterystyka, pielęgnacja i opieka

Rak żołądka to nowotwór rozwijający się w wyściółce żołądka, wymagający kompleksowej opieki pielęgniarskiej obejmującej ocenę objawów żołądkowo-jelitowych, stanu odżywienia, skutków ubocznych leczenia oraz aspektów psychospołecznych. Kluczowe jest monitorowanie bólu, nudności, wymiotów oraz zapobieganie powikłaniom takim jak zespół dumping po gastrektomii, który objawia się m.in. omdleniami, wzdęciami i biegunką. Pielęgniarka powinna stosować zarówno farmakologiczne, jak i niefarmakologiczne metody łagodzenia bólu i objawów, a także edukować pacjenta w zakresie żywienia, w tym konieczności spożywania małych, częstych posiłków oraz suplementacji witaminy B12 po zabiegu. Regularna ocena parametrów życiowych, badań laboratoryjnych i objawów klinicznych jest niezbędna do wczesnego wykrywania powikłań, takich jak krwawienia czy odwodnienie.

Opieka pielęgniarki nad pacjentem z rakiem żołądka

Rak żołądka (nowotwór żołądka) to choroba, w której komórki rakowe rozwijają się w wyścieleniu żołądka. Wymaga kompleksowej opieki pielęgniarskiej ukierunkowanej na zrozumienie patofizjologii, rozpoznawanie objawów oraz wdrażanie interwencji mających na celu zarządzanie objawami, zapobieganie powikłaniom i zapewnienie wsparcia emocjonalnego. Skuteczne leczenie raka żołądka zależy od wielu czynników, w tym od stopnia zaawansowania choroby i ogólnego stanu zdrowia pacjenta. Pielęgniarka odgrywa kluczową rolę w całościowej opiece nad pacjentem z rakiem żołądka, pomagając mu przejść przez wszystkie etapy choroby, od diagnozy przez leczenie po okres zdrowienia.123

Ocena stanu pacjenta

Kompleksowa ocena stanu pacjenta jest podstawą opieki pielęgniarskiej nad osobą z rakiem żołądka. Obejmuje ona:

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Ważną częścią oceny jest również dokładny wywiad obejmujący nawyki żywieniowe, utratę masy ciała (czas trwania i ilość), ocenę apetytu, historię palenia tytoniu i spożywania alkoholu, a także wywiad rodzinny w kierunku nowotworów przewodu pokarmowego. Badanie fizykalne powinno obejmować palpację i opukiwanie brzucha w poszukiwaniu tkliwości, mas lub wodobrzusza.3

Zarządzanie bólem

Zarządzanie bólem jest istotnym elementem poprawy jakości życia pacjenta z rakiem żołądka. Pielęgniarka powinna:

  • Podawać leki przeciwbólowe zgodnie z zaleceniami lekarza
  • Regularnie oceniać poziom bólu
  • Stosować metody niefarmakologiczne, takie jak odpowiednie ułożenie i techniki relaksacyjne dla dodatkowego komfortu
  • Podawać leki przeciwbólowe, gdy tylko pojawi się ból, przed jego nasileniem
  • Oceniać częstotliwość, intensywność i czas trwania bólu, aby określić skuteczność leków przeciwbólowych

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Oprócz metod farmakologicznych, pielęgniarka może pomóc w zarządzaniu bólem poprzez niefarmakologiczne metody takie jak: zmiany pozycji, techniki wizualizacji, odwracanie uwagi, ćwiczenia relaksacyjne, masaże, a także zapewnienie okresów odpoczynku i relaksu.12

Wsparcie żywieniowe

Pacjenci z rakiem żołądka często doświadczają problemów związanych z odżywianiem, które wpływają na ich stan zdrowia i samopoczucie. Wsparcie żywieniowe powinno obejmować:

  • Zachęcanie do spożywania małych, częstych posiłków
  • Rozważenie suplementów odżywczych
  • Współpracę z dietetykiem w celu indywidualnego planowania posiłków
  • Monitorowanie stanu odżywienia i wagi
  • Zapewnienie edukacji dotyczącej zmian w diecie po zabiegu

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Po gastrektomii pacjenci muszą zmienić sposób jedzenia, ponieważ żołądek nie może pomieścić tyle co wcześniej. Pielęgniarka powinna edukować pacjenta o konieczności jedzenia powoli i spożywania kilku małych posiłków dziennie. Pomaga to zapobiec zespołowi dumping, który występuje, gdy pokarm przechodzi zbyt szybko do jelita cienkiego. Zespół ten może powodować omdlenia, wzdęcia, drżenie, nudności i biegunkę.12

Ważne jest również podkreślenie znaczenia długoterminowych zastrzyków witaminy B12 po gastrektomii, aby zapobiec anemii złośliwej wywołanej zabiegiem chirurgicznym.1

Zarządzanie nudnościami i wymiotami

Nudności i wymioty są częstymi objawami związanymi z rakiem żołądka oraz skutkami ubocznymi leczenia. Pielęgniarka powinna:

  • Podawać leki przeciwwymiotne zgodnie z zaleceniami
  • Zapewnić spokojne środowisko
  • Sugerować zmiany w diecie, które mogą pomóc, jak unikanie silnych zapachów
  • Monitorować przyjmowanie płynów, aby zapobiec odwodnieniu

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W przypadku wymiotów lub biegunki należy zachęcać pacjenta do picia dużej ilości płynów, aby zapobiec odwodnieniu. Zaleca się wybór wody i innych przejrzystych płynów bez kofeiny. Gdy pacjent jest w stanie jeść, warto zaproponować czyste zupy, łagodne pokarmy i płyny, aż wszystkie objawy ustąpią. Inne dobre wybory to suche tosty, krakersy, gotowane płatki zbożowe i desery żelatynowe.12

Monitorowanie powikłań

Regularna ocena w kierunku powikłań jest kluczowa dla wczesnego wykrycia i interwencji. Pielęgniarka powinna:

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Należy natychmiast skontaktować się z lekarzem lub pielęgniarką, jeśli stolce pacjenta są czarne i wyglądają jak smoła lub mają smugi krwi, jeśli pacjent ma nowy lub silniejszy ból brzucha lub jeśli wymiotuje.1

Opieka psychospołeczna

Wsparcie emocjonalne

Diagnoza raka żołądka może mieć znaczący wpływ na stan emocjonalny pacjenta i jego rodziny. Pielęgniarka powinna:

  • Zapewnić wsparcie emocjonalne i kierować do usług doradztwa lub grup wsparcia
  • Pomóc pacjentowi wyrazić obawy, niepokoje i żal związany z diagnozą
  • Odpowiadać szczerze na pytania pacjenta
  • Zachęcać pacjenta do udziału w decyzjach dotyczących leczenia
  • Wspierać pacjenta w niedowierzaniu i czasie potrzebnym do zaakceptowania diagnozy

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Ważne jest, aby zapewnić zrelaksowaną, niegrożącą atmosferę, która pomaga pacjentowi wyrazić obawy, niepokoje i gniew. Pielęgniarka powinna również zachęcać rodzinę do wysiłków mających na celu wspieranie pacjenta, oferując zapewnienie i wspierając pozytywne mechanizmy radzenia sobie.1

Edukacja pacjenta i rodziny

Edukacja jest kluczowym elementem opieki nad pacjentem z rakiem żołądka. Pielęgniarka powinna:

  • Oferować kompleksową edukację na temat choroby, opcji leczenia i skutków ubocznych
  • Wspierać podejmowanie świadomych decyzji i aktywny udział w opiece
  • Nauczyć pacjenta znaczenia przestrzegania opieki paliatywnej i follow-up
  • Upewnić się, że pacjent rozumie wszystkie leki, w tym dawkowanie, drogę podania, działanie i niepożądane skutki

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Pacjent powinien być także poinformowany o potencjalnych powikłaniach i znaczeniu szybkiego zgłaszania wszelkich zmian. Pielęgniarka powinna również doradzać w sprawie wszelkich procedur i zabiegów.1

Opieka pooperacyjna

Po operacji raka żołądka (gastrektomii) pacjent wymaga szczególnej opieki pielęgniarskiej. Pielęgniarka powinna zwrócić uwagę na następujące aspekty:

Ryzyko nieefektywnego oczyszczania dróg oddechowych

Pacjent po zabiegu operacyjnym jest narażony na ryzyko nieefektywnego oczyszczania dróg oddechowych związane z gromadzeniem się wydzieliny na skutek znieczulenia ogólnego. Pielęgniarka powinna monitorować drożność dróg oddechowych, zachęcać do głębokiego oddychania i wykrztuszania, a w razie potrzeby przeprowadzać odsysanie.1

Ryzyko nieefektywnych wzorów oddychania

Znieczulenie ogólne może prowadzić do rozluźnienia mięśni gładkich i zaburzeń oddychania. Pielęgniarka powinna monitorować parametry oddechowe, zachęcać do ćwiczeń oddechowych i wczesnej mobilizacji.1

Ryzyko zmniejszonego rzutu serca

Utrata krwi podczas operacji może prowadzić do zmniejszonego rzutu serca. Pielęgniarka powinna monitorować parametry życiowe, bilans płynów i obserwować oznaki hipotensji.1

Ból ostry

Ból związany z nacięciem chirurgicznym wymaga odpowiedniego zarządzania. Pielęgniarka powinna podawać leki przeciwbólowe zgodnie z zaleceniami, oceniać poziom bólu i stosować niefarmakologiczne metody łagodzenia bólu.1

Ryzyko niezbilansowanej diety

Pacjenci po operacji żołądka są narażeni na problemy z odżywianiem związane z nudnościami, wymiotami, stanem NPO (nic doustnie) i nieadekwatnym przyjmowaniem pokarmów. Pielęgniarka powinna monitorować stan odżywienia, współpracować z dietetykiem i edukować pacjenta o specyficznych potrzebach żywieniowych po operacji.1

Ryzyko opóźnionego powrotu do zdrowia po operacji

Powikłania po operacji mogą opóźnić proces zdrowienia. Pielęgniarka powinna monitorować oznaki powikłań, zachęcać do wczesnej mobilizacji i zapewnić odpowiednią pielęgnację rany.1

Systemowa interwencja pielęgnacyjna

Systematyczne interwencje pielęgnacyjne są korzystne w zwiększaniu samoskuteczności i zdolności do samoopieki pacjentów oraz poprawianiu ich stanu fizycznego i psychicznego, łagodząc zmęczenie i poprawiając jakość życia. Badania pokazują, że systemowe interwencje pielęgnacyjne u pacjentów z rakiem żołądka w okresie okołooperacyjnym mogą znacząco poprawić ich stan zmęczenia, zdolność do samoopieki, samowystarczalność i jakość życia.12

Skuteczna realizacja interwencji pielęgnacyjnych jest również kluczową kwestią w badaniach klinicznych. W praktyce klinicznej konieczne jest przyjęcie aktywnej metody pielęgnacji pacjentów z rakiem żołądka, aby wyeliminować zmęczenie związane z rakiem (CRF), co poprawi samoskuteczność pacjentów, a co za tym idzie, poprawi rokowanie pacjenta.1

Współpraca wielodyscyplinarna w opiece nad pacjentem z rakiem żołądka

Leczenie raka żołądka wymaga współpracy wielu specjalistów, w tym gastroenterologów, chirurgów, onkologów, radioterapeutów, dietetyków, specjalistów od leczenia bólu i innych. Pielęgniarka jest kluczowym członkiem tego zespołu, koordynującym opiekę i zapewniającym ciągłość leczenia.12

Pielęgniarki-koordynatorki (nurse navigators) pomagają w planowaniu wizyt, koordynowaniu wizyt kontrolnych związanych z leczeniem i procedurami oraz prowadzą pacjenta przez aspekty przeżycia choroby nowotworowej. Są one integralną częścią opieki onkologicznej, pomagając pacjentom poruszać się po systemie opieki zdrowotnej, organizować wizyty i uzyskać dostęp do dodatkowych zasobów.12

Przygotowanie do wypisu i opieka domowa

Przygotowanie pacjenta do wypisu ze szpitala i kontynuacji opieki w domu jest ważnym elementem opieki pielęgniarskiej. Pielęgniarka powinna:

  • Edukować pacjenta w zakresie samoopieki w domu i wizyt kontrolnych
  • Zapewnić informacje o zespole opieki domowej, w tym o pielęgniarkach specjalizujących się w opiece paliatywnej
  • Pomóc w przygotowaniu planu opieki z wyprzedzeniem
  • Poinformować o dostępnych grupach wsparcia i zasobach społeczności

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Plan opieki z wyprzedzeniem (advance care plan) zawiera instrukcje dla lekarza i członków rodziny dotyczące rodzaju opieki, jakiej pacjent oczekuje, jeśli stanie się niezdolny do mówienia lub wyrażania siebie.1

W opiece domowej mogą uczestniczyć różni specjaliści, w tym pielęgniarki specjalizujące się w opiece paliatywnej (pielęgniarki Macmillan lub pielęgniarki hospicyjne), które specjalizują się w zarządzaniu objawami takimi jak kontrola bólu, nudności i inne objawy nowotworowe. Dietetyk środowiskowy może pomóc w radzeniu sobie z problemami żywieniowymi, sugerując sposoby radzenia sobie z trudnościami w odżywianiu.12

Opieka paliatywna w zaawansowanym raku żołądka

W przypadku zaawansowanego raka żołądka, który może być trudny do leczenia, celem leczenia jest ograniczenie raka i jego objawów oraz pomoc pacjentowi w dłuższym życiu. Zespół opieki paliatywnej pracuje z pacjentem, aby pomóc zarządzać objawami i uczynić go bardziej komfortowym.12

Leczenie paliatywne pomaga poprawić jakość życia pacjentów poprzez zarządzanie objawami raka bez próby wyleczenia choroby. Chodzi o to, aby pomóc pacjentowi żyć jak najdłużej w najbardziej satysfakcjonujący sposób, jaki jest możliwy. Leczenie może obejmować operację, stentowanie, radioterapię, chemioterapię lub inne leki. Zabiegi te mogą pomóc w zarządzaniu objawami takimi jak ból, krwawienie, trudności w połykaniu i nudności.1

Nawet jeśli leczenie nie niszczy ani nie kurczy raka, często istnieją sposoby łagodzenia bólu, problemów z jedzeniem i innych objawów. Ważne jest, aby natychmiast informować zespół opieki onkologicznej o wszelkich objawach, aby można było nimi skutecznie zarządzać.1

Wsparcie w przetrwaniu choroby nowotworowej

Po zakończeniu leczenia pacjenci z rakiem żołądka wymagają dalszej opieki, aby utrzymać zdrowie, pomóc w zarządzaniu objawami i upewnić się, że rak nie powrócił. Pacjenci otrzymują spersonalizowany plan opieki przetrwania, oparty na informacjach od zespołu opieki onkologicznej, który dostarcza informacji o przebytym leczeniu raka żołądka i oferuje wytyczne dotyczące wizyt kontrolnych i badań.1

Plan opieki przetrwania daje również porady dotyczące odżywiania, ćwiczeń i potencjalnych skutków ubocznych raka żołądka i jego leczenia. Celem jest zapewnienie pacjentowi wszystkich informacji i wsparcia, których potrzebuje, aby czuć się jak najlepiej.1

Po zakończeniu leczenia pacjenci zwykle odwiedzają zespół co trzy do sześciu miesięcy. Podczas wizyt pacjent zwykle przechodzi badanie fizykalne i rozmawia o wszelkich objawach, których doświadcza. Może również mieć badania laboratoryjne lub badanie endoskopowe górnego odcinka przewodu pokarmowego.1

Podsumowanie

Opieka pielęgniarska nad pacjentem z rakiem żołądka jest wielowymiarowa i obejmuje zarządzanie fizycznymi, emocjonalnymi i psychospołecznymi aspektami choroby. Pielęgniarka odgrywa kluczową rolę w ocenie stanu pacjenta, zarządzaniu bólem i innymi objawami, wspieraniu żywienia, monitorowaniu powikłań, zapewnianiu wsparcia emocjonalnego i edukacji pacjenta i rodziny. Współpraca z zespołem wielodyscyplinarnym jest niezbędna do zapewnienia najlepszej możliwej opieki.12

Rak żołądka, jeśli zostanie zidentyfikowany i leczony na wczesnym etapie, ma dobre rokowanie. Jednak pacjenci często zgłaszają się do szpitala dopiero w zaawansowanym stadium. Odpowiednie poradnictwo i szybka opieka pomogą pacjentom w szybkim powrocie do zdrowia i bezproblemowym okresie pooperacyjnym.1

Systematyczne interwencje pielęgnacyjne mogą znacząco poprawić stan zmęczenia, zdrowie psychiczne, zdolność do samoopieki, skuteczność własną i jakość życia pacjentów z rakiem żołądka w okresie okołooperacyjnym, co ma pozytywną wartość kliniczną.1

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer) | Free NURSING.com Courses
    https://nursing.com/lesson/nursing-care-plan-ncp-for-stomach-cancer-gastric-cancer
    To guide nursing professionals in delivering comprehensive care to patients with stomach cancer. This plan focuses on understanding gastric cancers pathophysiology, recognizing its symptoms, and implementing interventions for symptom management, complication prevention, and emotional support. […] Effective management of symptoms, including pain, nausea, and dietary difficulties. […] Prevention or early identification and management of complications, such as gastric obstruction or bleeding. […] Maintenance of nutritional status and body weight. […] Patient and family education about treatment options and lifestyle modifications. […] Assessment of Gastrointestinal Symptoms: Evaluate the nature, location, and severity of pain, nausea, and vomiting. […] Nutritional Status Assessment: Monitor for signs of malnutrition and weight loss.
  • #1 Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer) | Free NURSING.com Courses
    https://nursing.com/lesson/nursing-care-plan-ncp-for-stomach-cancer-gastric-cancer
    Evaluation of Treatment Side Effects: Monitor for side effects of chemotherapy or radiation, if applicable. […] Psychosocial Assessment: Assess the patients and familys understanding of the diagnosis and their coping mechanisms. […] Pain Management: Administer prescribed analgesics and assess pain levels regularly. Employ non-pharmacological methods like positioning and relaxation techniques for additional comfort. […] Nutritional Support: Encourage small, frequent meals and consider nutritional supplements. Collaborate with a dietitian for individualized meal planning. […] Management of Nausea and Vomiting: Administer antiemetics as prescribed. Provide a calm environment and suggest dietary changes that may help, like avoiding strong odors. […] Monitor for Complications: Regularly assess for signs of gastric bleeding, obstruction, or signs of metastasis. Early detection and intervention are vital.
  • #1 Supportive care for stomach cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/stomach/supportive-care
    Physical, psychological and complementary therapies can also be used to manage pain. These include massage, relaxation methods and deep breathing. […] Many people with stomach cancer have extreme tiredness (fatigue). Fatigue may be caused by the cancer or cancer treatment. […] Dumping syndrome occurs when food moves too quickly from the stomach into the small intestine. This may occur after surgery for stomach cancer if all or part of the stomach has been removed.
  • #1
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf9223
    Stomach cancer occurs when abnormal cells grow out of control in the stomach. Treatment depends on how far the cancer has spread and on your overall health. Treatments for stomach cancer can cause side effects, such as nausea or feeling very tired. Let your care team know about any symptoms so they can help you. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Take your medicines exactly as directed. Call your doctor or nurse advice line if you have any problems with your medicine. Follow your doctor’s instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe. If you had surgery, follow your doctor’s directions for eating after surgery. Get help from a dietitian if needed. You will feel full sooner than you did before. You’ll need to eat slowly and have several small meals a day. This can help prevent a problem called dumping syndrome, which happens when food goes into the small intestine too quickly.
  • #1 Gastric Cancer Nursing Care Plan and Management by RNpedia
    https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/gastric-cancer/
    Pain (acute) related to gastric erosion […] 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. […] Monitor nutritional intake and weigh patient regularly. […] Provide comfort measures and administer analgesics as ordered. […] Stress the importance of long term vitamin B12 injections after gastrectomy to prevent surgically induced pernicious anemia. […] Teach the patient the importance of compliance with palliative and follow-up care. Be sure the patient understands all medications, including the dosage, route, action, and adverse effects. […] Encourage the patient to seek psychosocial support through local support groups (e.g., I Can Cope), clergy, or counseling services. If appropriate, suggest hospice services. […] The patient can express fear, problems, and the possibility of anger due to the diagnosis and prognosis.
  • #1
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf9223
    If you are vomiting or have diarrhea: Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink. When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O. If you have not already done so, prepare an advance care plan. An advance care plan provides instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your stools are black and look like tar, or they have streaks of blood. You have new or worse belly pain. You are vomiting. Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you do not get better as expected.
  • #1 Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer) | Free NURSING.com Courses
    https://nursing.com/lesson/nursing-care-plan-ncp-for-stomach-cancer-gastric-cancer
    Patient and Family Education: Offer comprehensive education about the disease, treatment options, and side effects. Support informed decision-making and active involvement in care. […] Psychosocial Support: Provide emotional support and refer to counseling services or support groups. Addressing mental health is crucial for overall patient well-being. […] This care plan is dedicated to providing effective management of stomach cancer, addressing symptom relief, nutritional support, early identification of complications, and emotional support. Personalizing care based on the patients specific symptoms and needs is key for optimal management and improved quality of care.
  • #1 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Chemotherapy for further disease control or palliation (5-fluorouracil, cisplatin, doxorubicin, etoposide, mitomysin C) Radiation for palliation Tumor marker assessment to determine treatment effectiveness. […] Elicit history of dietary intake. Identify weight loss, including time frame and amount; assess appetite and eating habits; include pain assessment. Obtain smoking and alcohol history and family history (eg, any first- or second-degree relatives with gastric or other cancer). Assess psychosocial support (marital status, coping skills, emotional and financial resources). Perform complete physical examination (palpate and percuss abdomen for tenderness, masses, or ascites). […] Provide a relaxed, nonthreatening atmosphere (helps patient express fears, concerns, and anger). Encourage family in efforts to support the patient, offering assurance and supporting positive coping measures. Advise about any procedures and treatments.
  • #1
    https://journals.lww.com/ijcn/fulltext/2020/21020/care_of_patient_with_carcinoma_stomach.5.aspx
    Gastric cancer is not caused by just a single factor but a combination of genetic, socio-cultural and environmental factors. […] This paper outlines the nursing care of a patient Stomach cancer. […] The mode of treatment is chosen based on how long one has had the disease or what the stage of the cancer is. After the diagnostic laparoscopy, the patient with the tumour deemed resectable undergoes gastrectomy, if deemed unresectable then undergoes chemotherapy. […] Nursing management of a patient with cancer stomach is presented using a case report. […] Preoperatively, the patient was counselled for fear, anxiety, knowledge deficit and nutrition. […] The post-operative care is presented below based on the needs and problems of the patient. […] Nursing diagnosis: Risk for ineffective airway clearance related to pooling of secretions secondary to general anaesthesia.
  • #1
    https://journals.lww.com/ijcn/fulltext/2020/21020/care_of_patient_with_carcinoma_stomach.5.aspx
    Nursing diagnosis: Risk for ineffective breathing patterns related to the relaxation of smooth muscles secondary to general anaesthesia. […] Nursing diagnosis: Risk for decreased cardiac output related to blood loss during surgery. […] Nursing diagnosis: Acute pain related to surgical incision. […] Nursing diagnosis: Risk for imbalanced nutrition less than body requirement related to nausea, vomiting, Nil Per Oral (NPO) status and inadequate intake. […] Nursing diagnosis: Self-care deficit related to pain and fatigue secondary to surgery. […] Nursing diagnosis: Risk for delayed surgical recovery related to complications secondary to surgery. […] Nursing diagnosis: Deficient knowledge regarding home care and follow-up related to lack of information. […] Mrs. X surgery was uneventful, had hypotension on the 2nd post-operative day which was managed with IV fluids. […] Carcinoma stomach if identified and treated at an early stage has a good prognosis. However, patients present to the hospital only at an advanced stage. Appropriate counselling and prompt care will help patients to have a quick recovery and uneventful post-operative period.
  • #1 Systematic nursing interventions in gastric cancer: A randomized controlled study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8891775/
    Systematic nursing interventions are beneficial in enhancing the self-efficacy and self-care abilities of patients and improving their physical and mental state, thereby alleviating their fatigue and improving their quality of life. […] Systemic nursing intervention for GC patients during the perioperative period could alleviate cancer-related fatigue, improve self-efficacy and self-nursing ability, and improve quality of life, which all have clinical value. […] Effective implementation of nursing interventions is also a key issue in clinical research. Clinically, it is necessary to adopt an active nursing method for patients with GC to eliminate CRF, which will improve the self-efficacy of the patients, which in turn will improve patient prognosis. […] Systematic nursing interventions were administered to patients with GC during the perioperative period, and their effects on CRF, self-efficacy, self-nursing ability, and quality of life were analyzed.
  • #1 Stomach Cancer Treatment | Can You Treat Stomach Cancer? | American Cancer Society
    https://www.cancer.org/cancer/types/stomach-cancer/treating.html
    Stomach cancer is often treated by a team of doctors with different specialties. Most likely, your treatment team will include: A gastroenterologist: a doctor who specializes in treating diseases of the digestive system, A surgical oncologist: a doctor who treats cancer with surgery, A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy, targeted therapy, and immunotherapy, A radiation oncologist: a doctor who treats cancer with radiation therapy. […] Its important to discuss all of your treatment options, including their goals and possible side effects, with your treatment team to help make the decision that best fits your needs. […] One of the most important things to discuss is the goal of your treatment, including whether it might be possible to try to cure the cancer, or if treatment should be focused more on keeping the cancer under control for as long as possible and preventing or treating problems such as trouble eating, pain, or bleeding.
  • #1 Learn About Stomach Cancer
    https://www.rwjbh.org/treatment-care/cancer/types-of-cancer/gastrointestinal-cancer/stomach-cancer/
    Nurse navigators help secure appointments, coordinate follow-up visits related to treatments and procedures, and guide you through aspects of survivorship. […] Stomach cancer treatment options include: Surgery. Surgery may be performed to remove the cancerous tissue or to decrease bleeding and associated symptoms (palliative surgery). […] As the leader in cancer treatment in New Jersey, we provide the latest stomach cancer treatment options, leading to improved outcomes for this rare cancer type.
  • #1 Coping with stomach cancer | Cancer Research UK
    https://www.cancerresearchuk.org/about-cancer/stomach-cancer/living-with/coping
    Stomach cancer and its treatments are likely to cause physical changes in your body. These might affect the way you feel about yourself. […] Your dietitian can help you maintain your weight and your nurse can help you look at ways to cope with hair loss. […] If you have advanced cancer, community cancer nurses or symptom control nurses can help to support you at home. […] You might need some care and support at home due to stomach cancer or its treatment. Find out about practical and emotional support available to you. […] Your GP manages your healthcare when you are at home. They can help with any medical problems that come up. […] Community specialist palliative care nurses include Macmillan nurses and hospice nurses. They specialise in symptom management such as pain control, sickness, and other cancer symptoms.
  • #1
    https://www.nhs.uk/conditions/stomach-cancer/treatment/
    If you have advanced stomach cancer, it might be very hard to treat. It may not be possible to cure the cancer. […] The aim of your treatment will be to limit the cancer and its symptoms, and help you live longer. […] They will work with you to help manage your symptoms and make you feel more comfortable.
  • #1 Palliative Care for Stomach Cancer | Cancer Council NSW
    https://www.cancercouncil.com.au/stomach-cancer/treatment/palliative-treatment/
    Palliative treatment helps to improve people’s quality of life by managing the symptoms of cancer without trying to cure the disease. […] It is about helping you live for as long as possible in the most satisfying way you can. […] The treatment you are offered will be tailored to your individual needs, and may include surgery, stenting, radiation therapy, chemotherapy or other medicines. […] These treatments can help manage symptoms such as pain, bleeding, difficulty swallowing and nausea. […] Palliative treatment is one aspect of palliative care, in which a team of health professionals help meet your physical, emotional, cultural, spiritual and social needs. […] The team also supports families and carers.
  • #1 Stomach Cancer Treatment Choices by Stage | American Cancer Society
    https://www.cancer.org/cancer/types/stomach-cancer/treating/by-stage.html
    Treatment for these cancers is typically aimed at controlling the cancer growth for as long as possible and preventing or relieving any problems it causes. […] Treatment aimed at controlling the growth of the cancer might include chemotherapy alone, chemotherapy plus immunotherapy, or chemotherapy along with radiation therapy if a person is healthy enough. […] Even if treatments do not destroy or shrink the cancer, there are often ways to relieve pain, trouble eating, and other symptoms. It’s important to tell your cancer care team about any symptoms you have right away, so they can be managed effectively.
  • #1 logo–sylvester
    https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/cancer-survivorship-and-supportive-care/your-survivorship-information/stomach-cancer-survivorship
    If you’re a stomach cancer, also called gastric cancer, survivor, your relationship with your care team doesn’t stop after treatment has finished. You need ongoing care to keep you healthy, help manage any symptoms, and make sure cancer hasn’t returned. […] At Sylvester, you get personal attention and long-term guidance to help you live your best life. We offer complete stomach cancer survivorship services to enhance your well-being from supporting your emotional health and offering exercise guidance to personal assistance from our medical social workers and much more. You and your family can count on us every step of the way. […] Your survivorship visits are an essential part of supporting your good health. That’s why you receive a personalized survivorship care plan based on input from your cancer care team. This document provides you and your healthcare providers with an overview of your gastric cancer treatments and offers follow-up visits and testing guidance.
  • #1 logo–sylvester
    https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/cancer-survivorship-and-supportive-care/your-survivorship-information/stomach-cancer-survivorship
    Your survivorship care plan also gives you advice on nutrition, exercise, and potential side effects from stomach cancer and its treatment. Our goal is to make sure you have all the information and support you need to feel your best. […] After you’ve finished treatment, you can expect to see your team every three to six months. During your appointments, you’ll usually have a physical exam and talk about any symptoms you’re experiencing. You may also have lab tests or an upper endoscopy exam. You probably won’t have imaging tests unless you’re experiencing symptoms that need further examination. […] These appointments focus on all aspects of your health body, mind, and spirit. They’re an opportunity for you to discuss your concerns and get support from experts who can help. We make sure you know about all the cancer support services and education for you and your family at Sylvester, including cancer support groups.
  • #1 Systematic nursing interventions in gastric cancer: A randomized controlled study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8891775/
    Systematic nursing intervention could alleviate symptoms related to CRF in patients with GC during the perioperative period. […] Systematic nursing interventions could improve the self-efficacy and self-care abilities of patients with GC during the perioperative period. […] Systematic nursing intervention could improve the quality of life in patients with GC during the perioperative period. […] This study showed that the implementation of systematic nursing interventions in patients with GC during the perioperative period could significantly improve their fatigue state, mental health status, self-nursing ability, self-efficacy, and quality of life, all of which have a positive clinical value.
  • #2
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?HwId=uf9223
    Stomach cancer occurs when abnormal cells grow out of control in the stomach. […] Treatment depends on how far the cancer has spread and on your overall health. […] Treatments for stomach cancer can cause side effects, such as nausea or feeling very tired. Let your care team know about any symptoms so they can help you. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Take your medicines exactly as directed. Call your doctor or nurse advice line if you have any problems with your medicine. […] Follow your doctor’s instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. […] If you had surgery, follow your doctor’s directions for eating after surgery.
  • #2 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Chemotherapy for further disease control or palliation (5-fluorouracil, cisplatin, doxorubicin, etoposide, mitomysin C) Radiation for palliation Tumor marker assessment to determine treatment effectiveness. […] Elicit history of dietary intake. Identify weight loss, including time frame and amount; assess appetite and eating habits; include pain assessment. Obtain smoking and alcohol history and family history (eg, any first- or second-degree relatives with gastric or other cancer). Assess psychosocial support (marital status, coping skills, emotional and financial resources). Perform complete physical examination (palpate and percuss abdomen for tenderness, masses, or ascites). […] Provide a relaxed, nonthreatening atmosphere (helps patient express fears, concerns, and anger). Encourage family in efforts to support the patient, offering assurance and supporting positive coping measures. Advise about any procedures and treatments.
  • #2 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Encourage small, frequent feedings of nonirritating foods to decrease gastric irritation. Facilitate tissue repair by ensuring food supplements are high in calories and vitamins A and C and iron. Administer parenteral vitamin B12 indefinitely if a total gastrectomy is performed. Monitor rate and frequency of IV therapy. Record intake, output, and daily weights. Assess signs of dehydration (thirst, dry mucous membranes, poor skin turgor, tachycardia, decreased urine output). Review results of daily laboratory studies to note any metabolic abnormalities (sodium, potassium, glucose, BUN). Administer antiemetic agents as prescribed. […] Administer analgesic agents as prescribed (continuous infusion of an opioid). Assess frequency, intensity, and duration of pain to determine effectiveness of analgesic agent. Work with the patient to help manage pain by suggesting nonpharmacologic methods for pain relief, such as position changes, imagery, distraction, relaxation exercises (using relaxation audiotapes), back rubs, massage, and periods of rest and relaxation.
  • #2
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf9223
    Stomach cancer occurs when abnormal cells grow out of control in the stomach. Treatment depends on how far the cancer has spread and on your overall health. Treatments for stomach cancer can cause side effects, such as nausea or feeling very tired. Let your care team know about any symptoms so they can help you. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] Take your medicines exactly as directed. Call your doctor or nurse advice line if you have any problems with your medicine. Follow your doctor’s instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe. If you had surgery, follow your doctor’s directions for eating after surgery. Get help from a dietitian if needed. You will feel full sooner than you did before. You’ll need to eat slowly and have several small meals a day. This can help prevent a problem called dumping syndrome, which happens when food goes into the small intestine too quickly.
  • #2 Stomach Cancer | Baylor Medicine
    https://www.bcm.edu/healthcare/specialties/oncology/cancer-types/gastrointestinal-cancers/stomach-cancer
    Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may get medicine for nausea and vomiting if you have these side effects. […] Follow your doctors directions for eating after you have had surgery. You will need to eat slowly and to have several small meals a day, because you will feel full sooner than you did before. Diet guidelines will help prevent a problem called dumping syndrome, which happens when food goes into the small intestine too quickly. Dumping syndrome can make you feel faint, bloated, shaky, and nauseated, and have diarrhea. […] Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows. […] Take steps to control your stress and workload. Learn relaxation techniques.
  • #2
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf9223
    If you are vomiting or have diarrhea: Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink. When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O. If you have not already done so, prepare an advance care plan. An advance care plan provides instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your stools are black and look like tar, or they have streaks of blood. You have new or worse belly pain. You are vomiting. Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you do not get better as expected.
  • #2 Stomach Cancer | Baylor Medicine
    https://www.bcm.edu/healthcare/specialties/oncology/cancer-types/gastrointestinal-cancers/stomach-cancer
    If you are vomiting or have diarrhea: Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink. […] When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O. […] If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.
  • #2 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Help patient express fears, concerns, and grief about diagnosis. Answer patients questions honestly. Encourage patient to participate in treatment decisions. Support patients disbelief and time needed to accept diagnosis. Offer emotional support, and involve family members and significant others whenever possible; reassure that emotional responses are normal and expected.
  • #2 Gastric Cancer Nursing Care Plan and Management by RNpedia
    https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/gastric-cancer/
    Pain (acute) related to gastric erosion […] 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. […] Monitor nutritional intake and weigh patient regularly. […] Provide comfort measures and administer analgesics as ordered. […] Stress the importance of long term vitamin B12 injections after gastrectomy to prevent surgically induced pernicious anemia. […] Teach the patient the importance of compliance with palliative and follow-up care. Be sure the patient understands all medications, including the dosage, route, action, and adverse effects. […] Encourage the patient to seek psychosocial support through local support groups (e.g., I Can Cope), clergy, or counseling services. If appropriate, suggest hospice services. […] The patient can express fear, problems, and the possibility of anger due to the diagnosis and prognosis.
  • #2 Systematic nursing interventions in gastric cancer: A randomized controlled study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8891775/
    Systematic nursing intervention could alleviate symptoms related to CRF in patients with GC during the perioperative period. […] Systematic nursing interventions could improve the self-efficacy and self-care abilities of patients with GC during the perioperative period. […] Systematic nursing intervention could improve the quality of life in patients with GC during the perioperative period. […] This study showed that the implementation of systematic nursing interventions in patients with GC during the perioperative period could significantly improve their fatigue state, mental health status, self-nursing ability, self-efficacy, and quality of life, all of which have a positive clinical value.
  • #2
    https://winshipcancer.emory.edu/cancer-types-and-treatments/stomach-cancer/care-team/index.php
    Our cancer pain specialists provide interventional cancer pain management care tailored to address your specific pain symptoms. […] Oncology rehabilitation therapists are specially trained to address a variety of cancer-related impairments to help you before, during and after undergoing treatment for cancer. […] Our oncology social workers are here to offer practical assistance, support and individual, family and group counseling tailored to your needs. […] Our team of registered dietitians is here to provide guidance on managing your diet, weight, treatment side effects and the use of nutritional supplements.
  • #2 Stomach (Gastric) Cancer | MUSC Hollings Cancer Center
    https://hollingscancercenter.musc.edu/patient-care/cancer-types/gastrointestinal-cancers/stomach-cancer
    Whenever possible, our teams will use minimally invasive methods, like robotic surgery or laparoscopic surgery. […] To help you to adjust to life without a stomach, you will work with a dietitian who will guide you in what and when you need to eat. […] Our nurse navigators are an integral part of cancer care. They can help you to navigate through the health system, organize your appointments, and access additional resources. […] Your doctor may suggest a clinical trial believing that you could benefit from it. […] We pride ourselves on our holistic approach to cancer care. We offer you many resources to help you throughout your cancer journey, including financial counseling, physical therapy, nutrition services, and support groups.
  • #2 Coping with stomach cancer | Cancer Research UK
    https://www.cancerresearchuk.org/about-cancer/stomach-cancer/living-with/coping
    The community dietitian can help you cope with eating problems. They can suggest ways of dealing with diet difficulties. […] Social workers can help to support you with your situation at home. […] It might help to share your experiences with others who are going through the same thing. Your specialist nurse might refer you to a local support group. […] You can call the Cancer Research UK information nurses if you have questions or want to talk about coping with advanced cancer.
  • #2 Stomach Cancer Treatment Choices by Stage | American Cancer Society
    https://www.cancer.org/cancer/types/stomach-cancer/treating/by-stage.html
    Treatment for these cancers is typically aimed at controlling the cancer growth for as long as possible and preventing or relieving any problems it causes. […] Treatment aimed at controlling the growth of the cancer might include chemotherapy alone, chemotherapy plus immunotherapy, or chemotherapy along with radiation therapy if a person is healthy enough. […] Even if treatments do not destroy or shrink the cancer, there are often ways to relieve pain, trouble eating, and other symptoms. It’s important to tell your cancer care team about any symptoms you have right away, so they can be managed effectively.
  • #2
    https://journals.lww.com/ijcn/fulltext/2020/21020/care_of_patient_with_carcinoma_stomach.5.aspx
    Nursing diagnosis: Risk for ineffective breathing patterns related to the relaxation of smooth muscles secondary to general anaesthesia. […] Nursing diagnosis: Risk for decreased cardiac output related to blood loss during surgery. […] Nursing diagnosis: Acute pain related to surgical incision. […] Nursing diagnosis: Risk for imbalanced nutrition less than body requirement related to nausea, vomiting, Nil Per Oral (NPO) status and inadequate intake. […] Nursing diagnosis: Self-care deficit related to pain and fatigue secondary to surgery. […] Nursing diagnosis: Risk for delayed surgical recovery related to complications secondary to surgery. […] Nursing diagnosis: Deficient knowledge regarding home care and follow-up related to lack of information. […] Mrs. X surgery was uneventful, had hypotension on the 2nd post-operative day which was managed with IV fluids. […] Carcinoma stomach if identified and treated at an early stage has a good prognosis. However, patients present to the hospital only at an advanced stage. Appropriate counselling and prompt care will help patients to have a quick recovery and uneventful post-operative period.
  • #3
    https://apcz.umk.pl/JEHS/article/view/42765
    Gastric cancer is a malignant tumor that originates from the cells of the inner layer of the organ. It is characterized by a long asymptomatic period. The incidence of gastric cancer increases after the age of 50, especially in the male population. The aim of the study was to analyze selected aspects of nursing care provided to a patient after total gastrectomy in the course of gastric cancer. The patient has problems in the biopsychosocial sphere. The role of a nurse in caring for a sick person is comprehensive care, education and preparation for self-care, and above all mental support. Constant monitoring of the patient’s health greatly helps to prevent possible complications. […] Nursing care for the patient after gastric resection due to cancer.
  • #3 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Chemotherapy for further disease control or palliation (5-fluorouracil, cisplatin, doxorubicin, etoposide, mitomysin C) Radiation for palliation Tumor marker assessment to determine treatment effectiveness. […] Elicit history of dietary intake. Identify weight loss, including time frame and amount; assess appetite and eating habits; include pain assessment. Obtain smoking and alcohol history and family history (eg, any first- or second-degree relatives with gastric or other cancer). Assess psychosocial support (marital status, coping skills, emotional and financial resources). Perform complete physical examination (palpate and percuss abdomen for tenderness, masses, or ascites). […] Provide a relaxed, nonthreatening atmosphere (helps patient express fears, concerns, and anger). Encourage family in efforts to support the patient, offering assurance and supporting positive coping measures. Advise about any procedures and treatments.
  • #3 Cancer of Stomach – Easy explanation for Nurses- | PPT
    https://www.slideshare.net/slideshow/cancer-of-stomach-easy-explanation-for-nurses/140769873
    Encourage small, frequent feedings of nonirritating foods to decrease gastric irritation. Facilitate tissue repair by ensuring food supplements are high in calories and vitamins A and C and iron. Administer parenteral vitamin B12 indefinitely if a total gastrectomy is performed. Monitor rate and frequency of IV therapy. Record intake, output, and daily weights. Assess signs of dehydration (thirst, dry mucous membranes, poor skin turgor, tachycardia, decreased urine output). Review results of daily laboratory studies to note any metabolic abnormalities (sodium, potassium, glucose, BUN). Administer antiemetic agents as prescribed. […] Administer analgesic agents as prescribed (continuous infusion of an opioid). Assess frequency, intensity, and duration of pain to determine effectiveness of analgesic agent. Work with the patient to help manage pain by suggesting nonpharmacologic methods for pain relief, such as position changes, imagery, distraction, relaxation exercises (using relaxation audiotapes), back rubs, massage, and periods of rest and relaxation.
  • #3 Coping with stomach cancer | Cancer Research UK
    https://www.cancerresearchuk.org/about-cancer/stomach-cancer/living-with/coping
    Stomach cancer and its treatments are likely to cause physical changes in your body. These might affect the way you feel about yourself. […] Your dietitian can help you maintain your weight and your nurse can help you look at ways to cope with hair loss. […] If you have advanced cancer, community cancer nurses or symptom control nurses can help to support you at home. […] You might need some care and support at home due to stomach cancer or its treatment. Find out about practical and emotional support available to you. […] Your GP manages your healthcare when you are at home. They can help with any medical problems that come up. […] Community specialist palliative care nurses include Macmillan nurses and hospice nurses. They specialise in symptom management such as pain control, sickness, and other cancer symptoms.