Gastric Carcinoma

HEALTH TEACHING PLAN

Fernandez . Fortaleza . Garcia

BSN 3-G
The Objectives:
After 20 minutes of health teaching, the
client and family members will be able to:
1. Recognize important instructions that
will facilitate proper management of the
patient.
2. Verbalize understanding of the purpose
and benefits of following the given health
teaching.
3. Adapt healthy practices and behaviors
towards maintaining health and prevention
of disease
MEDICATIONS
Generic Name: Metronidazole Generic Name: Amikacin
Brand Name: Flagyl, Flagyl ER Brand Name: Amikin, Arikayce
Classification: Pharmacologic class: Nitroimidazole Classification: Pharmacologic class: Aminoglycoside
Therapeutic class: Antiprotozoal Therapeutic class: Antibiotic
H - (How will you know the drug is effective?) H - (How will you know the drug is effective?)
- Metronidazole is an antibiotic that may be used in the treatment of - Antibiotics are used to treat or prevent some types of bacterial
anaerobic infections caused by susceptible bacteria or parasites. infection. They work by killing bacteria or preventing them from
E - (Exact timing) reproducing and spreading.
Dosage: 500 mg E - (Exact timing)
Frequency: q6h Dosage: 500 mg
Timing: 6am, 12pm, 6pm, 12am Frequency: OD
Route: IV Timing: 8 am
C - (Client teaching – drug reactions/side effects) Route: IV
- Dizziness, headache, stomach upset, nausea, vomiting, loss of C - (Client teaching – drug reactions/side effects)
appetite, diarrhea, constipation, or metallic taste in your mouth may - skin rash, injection site reactions (pain, irritation, redness), drug fever,
occur. If any of these effects last or get worse, tell your doctor or headache, numbness and tingling, tremor, nausea, vomiting, joint pain,
pharmacist promptly. This medication may cause your urine to turn anemia, low blood pressure
darker in color. K - (Keys to remember)
K - (Keys to remember) - You should not use this medicine if you are allergic to amikacin or similar
- Take metronidazole at evenly spaced intervals during the day and with antibiotics such as gentamicin, kanamycin, neomycin, paromomycin,
food to minimize adverse GI reactions. avoid hazardous activities until streptomycin, or tobramycin. Watch for signs of ototoxicity, such as
drug’s CNS effects are known and to report any abnormal neurologic tinnitus and vertigo, especially during high-dosage or prolonged amikacin
signs or symptoms, such as numbness, seizures, weakness, or vision therapy
changes.
MEDICATIONS
Generic Name: Pantropazole
Brand Name: Protonix
Classification: Proton-pump inhibitors
H - (How will you know the drug is effective?)
- You can tell that pantoprazole is working if it reduces your GERD
symptoms, such as: heartburn, nausea, difficulty swallowing,
regurgitation, and sensation of a lump in your throat.
E - (Exact timing)
Dosage: 40 mg
Frequency: ODAC
Timing: 6am
Route: IV
C - (Client teaching – drug reactions/side effects)
- Common side effects include headaches, constipation or diarrhea,
wind, stomach pain, feeling or being sick. These tend to be mild and go
away when you stop taking the medicine.
K - (Keys to remember)
- It's usual to take pantoprazole once a day in the morning. Notify
prescriber if urine output decreases or there is blood in the patient’s
urine. Know that proton pump inhibitors such as pantoprazole should
not be given longer than medically
necessary.
Generic Name: Piperacillin + Tazobactam
Brand Name: ZOSYN
Classification: Penicillin Antibiotics and Beta- lactamase Inhibitor
H - (How will you know the drug is effective?)
- Piperacillin is in a class of medications called penicillin antibiotics. It
works by killing bacteria that cause infection. Tazobactam is in a class
called beta-lactamase inhibitor. It works by preventing bacteria from
destroying piperacillin.
E - (Exact timing)
Dosage: 2.25 g
Frequency: q8h
Timing: 8 am, 4 pm, 12 am
Route: IV
C - (Client teaching – drug reactions/side effects)
- diarrhea, constipation, nausea, vomiting, heartburn, stomach pain,
fever, headache.
K - (Keys to remember)
- For the best effect, use this antibiotic at evenly spaced times. To help
you remember, use this medication at the same time(s) every day.
Continue to use this medication for the full time prescribed, even if
symptoms disappear after a few days. Stopping the medication too early
may result in a return of the infection. Tell your doctor if your condition
lasts or gets worse.
MEDICATIONS
Generic Name: Levofloxacin Generic Name: Paracetamol/ Acetaminophen
Brand Name: Levaquin Brand Name: Biogesic
Classification: Fluoroquinolone antibiotic Classification: Analgesics
H - (How will you know the drug is effective?) H - (How will you know the drug is effective?)
- Levofloxacin is an antibiotic that may be used to treat certain bacterial - Paracetamol is thought to reduce the intensity of pain signals to the
infections. brain and reduce fever.
E - (Exact timing) E - (Exact timing)
Dosage: 500 mg per vial Dosage: 500 mg in 100 cc
Frequency: OD Frequency: q8h
Timing: 6am Timing: 8 am, 4 pm, 12 am
Route: IV Route: IV
C - (Client teaching – drug reactions/side effects) C - (Client teaching – drug reactions/side effects)
- Common side effects include: nausea, stomach pain, loss of appetite, - diarrhea, constipation, nausea, vomiting, heartburn, stomach pain,
itching, rash, headache, dark urine, clay-colored stool, jaundice, severe fever, headache.
dizziness, trouble breathing. K - (Keys to remember)
K - (Keys to remember) - May be administered without regard to food; although food may
- Take levofloxacin at least two hours before or two hours after decrease any reported stomach upset. Do not exceed the recommended
antacids or preparations containing iron or zinc. Should be taken exactly dosage, because this may put you at risk of liver toxicity. Seek urgent
as directed and for the time period indicated to reduce the risk of medical attention if you develop pain in your upper abdomen, dark urine,
resistant bacteria developing, unless side effects force early loss of appetite, yellowing of the skin or eyes or clay-colored stools.
discontinuation. Ensure you keep hydrated while taking levofloxacin to
prevent crystal formation in your urine.
MEDICATIONS
Generic Name: Leucovorin
Brand Name: Wellcovorin
Classification: Folic acid antagonist; Antidote
H - (How will you know the drug is effective?)
- Leucovorin is used to prevent harmful effects of methotrexate when
methotrexate is used to treat certain types of cancer. It works by
protecting healthy cells from the effects of methotrexate or similar
medications while allowing methotrexate to enter and kill cancer cells.
E - (Exact timing)
Dosage: 200 mg per m2
Frequency: OD
Timing: 6am
Route: IV
C - (Client teaching – drug reactions/side effects)
- Excessive dosage may negate chemotherapeutic effects of folic acid
antagonists. Anaphylaxis occurs rarely. Diarrhea may cause rapid clinical
deterioration.
K - (Keys to remember)
- Use this medication regularly to get the most benefit from it. To help
you remember, take it at the same time(s) each day.
Generic Name: 5-Fluorouracil
Brand Name: Carac
Classification: Antimetabolites
H - (How will you know the drug is effective?)
- Fluorouracil is part of a group of chemotherapy drugs known as anti
metabolites. They stop the cells making and repairing DNA. Cancer cells
need to make and repair DNA so that they can grow and multiply.
E - (Exact timing)
Dosage: 600 mg
Frequency: OD
Timing: 8 am
Route: IV
C - (Client teaching – drug reactions/side effects)
- Risk of infection. This treatment can reduce the number of white blood
cells in your blood, bruising and bleeding, anaemia (low number of red
blood cells), feeling sick, diarrhea, sore mouth and throat, loss of
appetite, changes to your taste.
K - (Keys to remember)
- Do not receive any kind of immunization or vaccination without your
doctor's approval while taking Fluorouracil. Use of ice chips in the mouth
10-15 minutes before and after IV injections of Fluorouracil may reduce
the incidence and severity of mouth sores. Maintain good nutrition. Get
plenty of rest. Remain as active as you are able. Gentle exercise is
encouraged, such as a daily walk.
 - Promoting overall fitness

- Boosting their energy level

- Improving their immune System

EXERCISE
- Boosting their spirit and improving their emotional outlook

*Note that it's best to start with small and simple exercises such as light walking and
Exercise has many benefits jogging, and to avoid heavy lifting or anything that may cause fatigue.

that may help the patient *It is also best to consult with a doctor beforehand to choose safe exercises and
withstand the physical and consider talking to a trainer who can help with designing an exercise program.
emotional stresses of cancer

*Physical Therapy may also be utilized during cancer treatment to help a patient
and its treatment including: maintain function. One example is Lymphatic Therapy. This can help minimize the
effects of possible lymphedema which can occur in conjunction with gastric cancer
treatment.
 TREATMENT
Seven various types of standard treatment used to treat
Gastric Carcinoma include:
SURGERY
is a common treatment of all stages of gastric cancer.
Specifically, there is Subtotal Gastrectomy which is a removal
of the part of the stomach, and Total Gastrectomy which is a
removal of the entire stomach.

ENDOSCOPIC MUCOSAL RESECTION

a procedure that uses an endoscope to remove early-stage
cancer and precancerous growths from the lining of the
digestive tract without surgery. An endoscope is a thin, tube-
like instrument with a light and a lens for viewing. It may also
include tools to remove growths from the lining of the
digestive tract.
CHEMOTHERAPY
a cancer treatment that uses drugs to stop the growth of
cancer cells, either by killing the cells or by stopping them
from dividing.

RADIATION THERAPY
a cancer treatment that uses high-energy x-rays or other
types of radiation to kill cancer cells or keep them from
growing.
CHEMORADIATION
combines chemotherapy and radiation therapy to increase
the effects of both..

TARGETED THERAPY
is a type of treatment that uses drugs or other substances
to identify and attack specific cancer cells. Targeted
therapies usually cause less harm to normal cells than
chemotherapy or radiation therapy do.
 IMMUNOTHERAPY
It is a treatment that uses the patient's immune system to
fight cancer. Substances made by the body or made in a
laboratory are used to boost, direct, or restore the body's
natural defenses against cancer.
 Wash hands thoroughly and often.
Hand washing is the most effective method of
decreasing the chance of catching colds and flu.
Always carry a hand sanitizer for times when

HYGIENE
Cancer and its treatments suppress the
washing is not convenient.
Try to avoid crowds, especially during cold and
flu season.
body's immune system and can increase
the risk of infection. To reduce the risk of
infection it is important to:
Avoid touching eyes, mouth, and nose after coming in
contact with surfaces or objects.

Clean and disinfect surfaces and objects often.

OUTPATIENT
Radiation Therapy
Follow up

Take medication as prescribed

Examinations Practice oral hygiene
Eat smaller and frequent Inform family about the

meals to manage side effects condition and how

to manage it
like pain and nausea Eat a well balanced meal
Exercise daily

DIET
Eat lean meats like chicken, fish, or turkey
Lowfat dairy products like milk, yogurt,
and cheese
Whole grains like oatmeal and whole WHAT TO AVOID?
wheat bread Limit the consumption of alcoholic beverages
Eat a variety of Fruits and Vegetables Limit the consumption of sweets or foods
Choose sources of healthy fat from containing added sugars
avocados, nuts, and olive oil. Limit eating processed foods
Stay hydrated and drink an adequate Avoid dairy after surgery
amount of water