Chapter 41: Stomach Cancer

Question 1

Cite the most common type of stomach cancer.

Answer 1

Adenocarcinoma of the stomach wall

Question 2

Cite the demographics of people of increased incidence diagnosed with stomach cancer.

Answer 2

Asian American, pacific Islander, Hispanic, and Black

Question 3

List dietary factors that predispose one to stomach cancer.

Answer 3

Diets high in smoked foods, salted fish and meat, pickled veggies

Question 4

Identify which bacteria is a risk factor for developing stomach cancer.

Answer 4

H. pylori

Question 5

Cite which organ stomach cancer often spreads to.

Answer 5

Spreads by direct expansion to liver and adjacent tissue

Question 6

Describe clinical manifestations of stomach cancer (2)

Answer 6

• GI: unexplained wt loss, indigestion, abd pain/discomfort, early satiety (a sense of being full sooner than usual)

*Anemia: ple, weak, fatigue, dizzy, SOB, heme + stool

Question 7

Name late signs of stomach cancer metastasis. (2)

Answer 7

Metastasis/late signs: Supraclavicular lymph node enlargement, ascites

Question 8

Cite the best diagnostic tool used for detecting stomach cancer.

Answer 8

Upper GI endoscopy

Question 9

Discuss other laboratory findings that could indicate gastric cancer.

Answer 9

Endoscopy, ultrasound, CT, MRI, PET scan, laparoscopy, blood studies, liver enzymes, stool examination

Question 10

Describe surgical procedures to remove stomach cancer. (3)

Answer 10

*Lesions in the antrum or pylorus: Billroth I or III (Billiroth procedure: the creation of an anastomosis between the duodenum and the gastric remnant)

*Lesions in the fundus: total gastrectomy w/ esophagojejunostomy

*Other: depends if the areas of metastasis

Question 11

Review the use of chemotherapy and radiation therapy for treating gastric cancer. (3)

Answer 11

1. Combo chemo preferred
2. May be given intraperitoneal for metastasis
3. Radiation may be done with chemo or as palliative tx for obstruction or to reduce tumor mass

Question 12

List 4 nursing diagnoses and expected outcomes for patients diagnosed with stomach cancer.

Answer 12

1. Impaired nutritional intake
2. Impaired nutritional status
3. Acute pain
4. Anxiety

Question 13

Review use of nutritional needs due to stomach cancer and subsequent treatment. (7)

Answer 13

1. Poor appetite, wt loss, fatigue, persistent stomach distress are all symptoms of stomach cancer
2. Because of changes in appetite early satiety, the patient may be malnourished. Surgery may be delayed until pt is more physically able to withstand it.
3. Pt may better tolerate several small meals than 3 large ones
4. May be challenging to get pts to eat when they have no appetite and are depressed
5. Involve pt caregivers to help with meals and encourage pt intake.
6. Dietary supplements may be used: liquid supplements and vitamins
7. If pt unable to ingest oral feeding, EN or PN may be prescribed