UNIT 8 GASTRECTOMY Flashcards
What is a Gastrectomy?
Removal of stomach due to cancer – could be from ulcers that turn malignant
gastrectomy Surgical removal of all (total gastrectomy) or part (subtotal gastrectomy) of the stomach.
NGT, TPN, reduced intrinsic factor -vit B12, iron, folic acid, calcium
Dumping syndrome
Dumping Syndrome
This syndrome is believed to occur as a result of the rapid emptying of food contents into the small intestine, which shifts fluid into the gut, causing abdominal distention. food contents into the small intestine, which shifts fluid into the gut, causing abdominal distention. Observe for early manifestations of this syndrome, which typically occur within 30 minutes of eating. Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. Report these manifestations to the surgeon, and encourage the patient to lie down. Monitor the patient for late symptoms.
Late dumping syndrome, which occurs 90 minutes to 3 hours after eating, is caused by a release of an excessive amount of insulin. The insulin release follows a rapid rise in the blood glucose level that results from the rapid entry of high-carbohydrate food into the jejunum. Observe for manifestations, including dizziness, light-headedness, palpitations, diaphoresis, and confusion.
Dumping syndrome is managed by nutrition changes that include decreasing the amount of food taken at one time and eliminating liquids ingested with meals. In collaboration with the registered dietitian nutritionist, teach the patient to eat a high-protein, high-fat, low- to moderate-carbohydrate diet (Table 50.3). Acarbose may be used to decrease carbohydrate absorption. A somatostatin analog, octreotide, 50 mcg subcutaneously two or three times daily 30 minutes before meals, may be prescribed in severe cases. This drug decreases gastric and intestinal hormone secretion and slows stomach and intestinal transit time.
Delayed gastric emptying is often present after gastric surgery and usually
