Critical Thinking Exercise:

Nursing Management of the client with GI Cancer

Rafin, Marinel F. BS III-D

SITUATION: You are caring for a 61-year-old woman who was admitted for wight loss, decreased
appetite, early satiety, and indigestion. Gastric cancer is the probable diagnosis.

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1. What questions should you ask this patient?

The following are the possible questions that is included in the assessment of a gastric cancer:

 Dietary history from the patient, focusing on recent nutritional intake and status.
 Since the patient has lost weight, how much and what period of time?
 Can the patient tolerate a full diet? If not, what food he/she eats?
 What other changes in eating habits have occurred?
 Is the patient in pain? If she is in pain, Do foods, antacids or medications relieve the pain, make
no difference or worsen the pain?
 Is there a history of infection with H. Pylori bacteria?
 Family history of gastric cancer?
 Is the patient do smoke or drink alcohol?
 Ask about his psychosocial and psychological coping strategies
 Ask about social support and financial resources.

2. What diagnostic studies and treatment plan would you anticipate for this patient?

Diagnostic studies that can be anticipated to the patient includes endoscopy for biopsy and
cytologic washings, X-ray examination of the upper GI tract with barium may also be done, a computed
tomography (CT) Scan is used to determine the presence of cancer cells and if already metastasized.

Treatment plan would include interventions that helps to reduce anxiety, attaining optimal
nutrition, relieving pain and adjusting to the diagnosis and to anticipated lifestyle changes. Providing
social support is also necessary for the patient.
3. What nursing diagnoses, including knowledge deficit, would you anticipate for this patient?

Based on the assessment data, the patient’s major diagnosis may include the following:

 Anxiety related to the disease and anticipated treatment

 Altered nutrition, less than body requirements, related to anorexia
 Pain related to the presence of abnormal epithelial cells
 Anticipatory grieving related to the diagnosis of cancer
 Knowledge deficit regarding self-care activities