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Cancer of the Stomach and Liver

Cancer of the Stomach and Liver

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Published by james garcia

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Published by: james garcia on Sep 28, 2009
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05/21/2012

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Cancer of the Stomach
Cancer of the stomach is usually adenocarcinoma.
It typically occurs in males and people older than age 40.
Mostly occur in lesser curvature or antrum of the stomach and infiltratesurrounding mucosa, stomach wall, adjacent organs and structures.
Prognosis is poor because most patients have metastases at the time of diagnosis.
Etiology
Diet – high in smoked food and lacking in fruits and vegetables
Chronic inflammation of the stomach
Pernicious anemia
Achlorydria
Gastric ulcers
Helicobacter pylori 
bacteria ]
Heredity
Clinical Manifestations
Early stages: symptoms may be absent or may resemble those of the patientwith benign ulcers (eg, pain relieved with antacids)
Progressive disease: symptoms include:
Indigestion
Anorexia
Dyspepsia
Weight loss
Abdominal pain
Constipation
Anemia
Nausea and vomiting
Ascites
Diagnostic Methods
Radiography of the upper gastrointestinal system with barium.
Endoscopy for biopsy and cytologic washings.
 
CT scan, bone scan and liver scan to determine extent of metastasis.
Complete radiographic examination of the gastrointestinal tract if dyspepsia of more than 4 weeks’ duration in any person older than 40 years of age.
Medical Management
Removal of gastric carcinoma; curative if tumor can be removed while stilllocalized to the stomach.
Effective palliation (to prevent symptoms such as obstruction) by resection of thetumor; radical subtotal gastrectomy; total gastrectomy with anastomosis of theesophagus and jejunum
Chemotherapy
Radiation therapy
Nursing InterventionsReducing anxiety
Provide relaxed, nonthreatening atmosphere
Advise about any procedure and treatment
Suggest patient to discuss feelings
Promoting optimal nutrition
Encourage small, frequent feedings of non irritating foods to decrease gastricirritation
Ensure that food supplements are high in calories and vitamins A and C and iron.
Administer parenteral vitamin B
12
indefinitely if total gastrectomy is performed
Monitor rate and frequency of IV
Record intake and output, amd daily weights
Administer antiemetics as prescribed
Relieving pain
Administer analgesics as prescribed
Assess frequency, intensity and duration of pain to determine effectiveness of analgesic agent
Suggest non pharmacologic methods for pain relief (eg imagery, distraction,relaxation tapes, back rubs and massage)
Encourage periods of rest and relaxation.
 

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