Goals:
Maintain normal range of body mass index in the course of postoperative care after one week treatment with no complications occur.
Understand nutritional treatment at home after total gastrectomy.
Problems:
Nutritional risk
Education to the patients related to postoperative nutritional care after total gastrectomy.
Evidences:
Nutritional risk related to newly commenced total parenteral nutrition (TPN).
Patient has knowledge deficit related to postoperative nutritional care after total gastrectomy.
Nursing Intervention for nutritional risk:
Observe the tube insertion site. See if there is any inflammation, redness,swelling or tenderness. Ensure the dressing is intact and changed everyday to monitor the sign of infection and prevent
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After total gastrectomy, small intestine has to drawn in water from the rest of the body to help break down food.Patient will suffer from severe abdominal cramping, nausea, vomiting, diarrhea, sweating, dizziness,cramps.Evaluate the dose and rate of administration to relieve dumping syndrome.
Educate the patient about eating habit to prevent dumping syndrome when resume feeding.Dumping syndrome will make the patient difficult to get daily required calories to maintain or retain weight. To promote weight gain, eat calorie dense food to maintain body weight. Eat small frequent meals and eat more variety of food, but make sure to include fruits and vegetables other than high calories food.
Prevent dumping syndrome when the patient resume fasting.Ask patient to eat at room temperature,because temperature extremes will stimulate peristalsis, more easier to have dumping syndrome. Advise the patient to remain in semi-Fowler’s position for at least 30 minutes(most suitable is 1 hour)after feeding: the position prolongs intestinal transit time by decreasing the effect of