Stomach Disorders: Gastric cancer, Gastrectomy, & Bariatric surgery Post-op Flashcards
Gastric cancer
Risk factors diseases?
H. Pylori
Gastric polyps
Pernicious anemia
Gastric cancer
Risk factor foods?
Pickled foods
Nitrates
Added salt to food
Gastric cancer
Risk factor if lack of what foods?
Lac of fruits and veg
Gastrectomy is the main tx for what?
Gastric cancer
Gastrectomy post op
NG tube is connected to ____
Low suction to empty stomach
*if whole stomach removed, the NG tube put in small intestine until bowel function returns
Gastrectomy post op
NPO until when? Then what?
Stomach wakes up then
Clear liquids after audible bowel sounds/pt has BM
Then liquids, then soft food, then solid food
Gastrectomy post op
Eat what once starting to eat?
Small meals
More protein
Less sugar
Gastrectomy post op
When to get pt up?
Out of bed day after surgery
*abdominal binder/splinting may be needed to reduce pain
Gastrectomy post op
What could happen–dumping or refeeding?
Dumping
Bariatric post op
Priority?
Airway
- Postion
- SaO2 monitor
- note: pt. with thin and short neck veins often have compromised airways and need aggressive support
Bariatric post op
T/F: Need abdominal binder
T
Bariatric post op
How to control pain?
PCA with mophine for first 24 hr then oral opioids (liquid form preferred) after PCA d/c
Bariatric post op
Pt still large after this surgery?
Yes focus on your safety and theirs!!
Bariatric post op
How to be safe with big pt?
- Extra wide bed (bed rails shouldn’t touch pt)
- Beds need to have adequate weight maximums
- Extra personnel for moving/turning pt
Bariatric post op
Should pt lift anything post op
No
Bariatric post op
How to do skin assessment?
- Monitor between skin folds and around tubes/catheters
- Skin kept clean and dry
- Use absorbent padding between folds
- Turn q2h
Bariatric post op
NG tube management?
- May be placed, if so monitor tube for potency
- NEVER reposition tube bc movement can disturb suture line
- Will be removed 2nd day after pt. passes gas
Bariatric post op
Diet order?
- Clear liquid slowly introduced after surgery in small 1 oz cup
- Pureed, foods, juice, thinned soups, milk for 24-48 hours later and on this for SIX weeks!!!
- 6 small feeds to prevent dehydration
Bariatric post op
Observe for what-dumping or refeeding?
DUmping syndrome
Dumping can occur especially after?
Gastric bypass
Symptoms of dumping?
Tachycardia
Nausea
Diarrhea
Ab. cramping
When to remove catheter?
Within 24 hours to prevent UTI
