Convincing Features
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Subject
Uploaded by Malaysia Assignment Help
Date
| No. | Criteria |
|---|---|
| 1 | Patient’s Background Information |
| Personal Data. | |
| Chief complaint. | |
| History of present illness. | |
| Current medical problem and condition | |
| Pathophysiology of disease/condition (learned in current semester). | |
| Past medical/surgical history/ medications /allergy | |
| Family history/ Social history. | |
| 2. | Medical management |
| Physical assessment. | |
| Diagnostic investigations and laboratory tests & others. | |
| Differential diagnoses | |
| Actual diagnoses | |
| Management plans: treatment (e.g medication, IVD, dressing etc). | |
| Discharge/ follow up/ summary of patient’s problem. | |
| 3 | Nursing Management |
| Identification of actual/potential nursing diagnosis. | |
| Identification of relevant goal / outcomes | |
| Identification of relevant planning/interventions and rationales. | |
| Arrangement of nursing care plan according to priority. | |
| Application of evidence based practiced in the nursing management | |
| Demonstrates critical thinking about the topic and the student’s own impression and interpretation of the case | |
| 4 | Formatting |
| The writing presentation of the portfolio is an academically sounds and professional. | |
| Application of proper citing of references accordance to APA style (version 8) | |
| Demonstrate of proper sentences grammar, structure, punctuation, and spelling. | |
| Font must be using Arial, size 11, paragraph in justify with line spacing 1.5 | |
| 5. | Submission of the assignment |
| White cover with UiTM logo, student’s name, matrix number, title of the assignment, year & code course | |
| Black tape or black comb binding | |
| Attach the Turnitin report (< 30% similarity) |
Smeltzer, S.C., & Bare, B.G. (2000). Textbook of Medical Surgical Nursing. (9th ed.).
Philadelphia; Lippincott.
Students will be directed to relevant texts, journals, and readings during the course.
Submission: 10/01/2026
Date: 24/01/2026 @ Medical surgical lab
Time: 7.30am – 1030am.
CENTRE FOR NURSING STUDIES
FACULTY OF HEALTH SCIENCES
UiTM SELANGOR, PUNCAK ALAM CAMPUS
BACHELOR OF NURSING (HONS)
GROUP: NHSN10B
MANAGEMENT CLIENTS WITH GASTROINTESTINAL DISORDERS
Gastric cancer, commonly known as stomach cancer, is a serious global health problem with high morbidity and mortality, particularly when diagnosed at an advanced stage (Bray et al., 2021). It develops from malignant changes in the gastric mucosa and often progresses slowly with few early symptoms. Patients frequently present with non-specific gastrointestinal symptoms such as early satiety, nausea, vomiting, and unexplained weight loss, which can lead to delayed diagnosis and complex treatment needs (Rawla & Barsouk, 2019).
Management of gastric cancer requires a multidisciplinary approach that may include surgery, chemotherapy, and radiotherapy, depending on the stage of the disease. Surgical procedures such as partial or total gastrectomy remain the main curative treatment, but they significantly alter gastrointestinal structure and function, increasing the risk of complications such as malnutrition, dumping syndrome, and impaired gastrointestinal motility (Lewis et al., 2023).
Nurses play a key role in caring for patients with gastric cancer through comprehensive assessment, accurate nursing diagnoses, appropriate interventions, and continuous evaluation. The nursing care process provides a structured and evidence-based approach to manage nutritional problems, prevent post-gastrectomy complications, and support optimal gastrointestinal function (Potter et al., 2021). This assignment focuses on the nursing management of patients with gastric cancer using the nursing care process, with emphasis on selected nursing diagnoses related to the disease and its treatment.
Medical management of gastric cancer is determined by tumour stage, location, histopathology, and the patient’s overall health status. A multidisciplinary healthcare team is essential to achieve optimal outcomes, with the main goals being tumour control, symptom relief, prevention of complications, and improvement of quality of life (Hinkle & Cheever, 2022).
Upper gastrointestinal endoscopy with biopsy is the gold standard for diagnosing gastric cancer. Imaging modalities such as computed tomography (CT) scans are used to assess tumour staging, lymph node involvement, and metastasis. Additional investigations, including endoscopic ultrasound, help determine tumour depth, while laboratory tests such as full blood count and serum albumin identify anaemia and nutritional deficiencies (Lewis et al., 2023).
Surgery is the primary curative treatment for localized gastric cancer. Partial gastrectomy is performed when the tumour is confined to one region of the stomach, whereas total gastrectomy is indicated for extensive disease. Lymph node dissection is commonly performed to reduce recurrence risk. Although surgery improves survival, it often results in reduced gastric capacity, malabsorption, dumping syndrome, and impaired gastric motility (Hinkle & Cheever, 2022).
Chemotherapy may be given before surgery to reduce tumour size or after surgery to eliminate residual cancer cells. In advanced disease, it is mainly palliative. Radiotherapy is often combined with chemotherapy to improve local tumour control. Common adverse effects include nausea, vomiting, mucositis, fatigue, and loss of appetite, which further compromise nutritional status (Smeltzer et al., 2020)
Management for Nursing Care
Medical and surgical treatments for gastric cancer significantly affect gastrointestinal function and nutrition. Nurses must monitor patients closely for post-gastrectomy complications, chemotherapy-related side effects, and signs of malnutrition. Understanding medical management enables nurses to anticipate patient needs and provide timely, targeted nursing interventions.
Nursing management is essential in providing holistic care for patients with gastric cancer, as the disease and its treatment affect physical, nutritional, and psychological well-being. Effective nursing care focuses on early detection of complications, symptom management, nutritional support, and patient education.
Nurses provide continuous, patient-centred care from diagnosis to recovery or palliative stages. Key responsibilities include performing systematic assessments, administering treatments, monitoring responses, coordinating multidisciplinary care, and educating patients and families. Emotional and psychosocial support is equally important, as patients may experience anxiety, fear, and altered body image following diagnosis (Potter et al., 2021).
Comprehensive assessment is fundamental in identifying patient problems and planning appropriate care.
3.2.1 Gastrointestinal Assessment
Monitoring nausea, vomiting, early satiety, abdominal distension, bowel sounds, and food tolerance.
3.2.2 Nutritional Assessment
Monitoring body weight, body mass index, dietary intake, appetite, serum albumin, and haemoglobin levels.
3.2.3 Post-Gastrectomy and Treatment-Related Assessment
Treatment-Related Assessment
Identifying symptoms of dumping syndrome and monitoring chemotherapy-related side effects such as mucositis and fatigue.
The nursing care process includes assessment, nursing diagnosis, planning, implementation, and evaluation, and is essential for managing the complex physiological changes associated with gastric cancer and its treatment.
Through thorough assessment, nurses identify problems such as nutritional deficits, altered digestion, and post-gastrectomy complications, which guide the formulation of appropriate nursing diagnoses and targeted interventions. In this assignment, the nursing care process is applied to patients with gastric cancer, focusing on imbalanced nutrition, risk for dumping syndrome, and impaired gastrointestinal motility to prevent complications, support recovery, and improve patient outcomes.
4.1.1 Assessment Findings
Reduced gastric capacity, impaired digestion, and treatment effects from gastrectomy and chemotherapy, as evidenced by unintentional weight loss, early satiety, decreased oral intake, nausea, vomiting, and hypoalbuminaemia.
4.1.2 Nursing Diagnosis Statement
Imbalanced nutrition: less than body requirements
4.1.3 Goals and Expected Outcomes
Short-term goals:
Long-term goals:
4.1.4 Nursing Interventions and Rationales
| Nursing Interventions | Rationales |
| Assess the patient’s dietary intake, weight, and tolerance to food on a daily basis. | Continuous assessment allows early identification of nutritional deficits and evaluation of intervention effectiveness. |
| Encourage small, frequent meals rather than large meals. | Reduced gastric capacity following tumour growth or gastrectomy limits the volume of food tolerated at one time. |
| Collaborate with a dietitian to develop an individualised high-protein, high-calorie diet plan. | Interdisciplinary collaboration ensures adequate nutritional support tailored to altered digestive capacity. |
| Monitor laboratory parameters such as serum albumin and haemoglobin levels. | These indicators reflect the patient’s nutritional and metabolic status. |
| Provide nutritional supplements as prescribed. | Supplements help meet caloric and protein requirements when oral intake is insufficient. |
| Educate the patient on dietary modifications and symptom management strategies. | Patient education promotes adherence and empowers self-management of nutritional challenges. |
4.1.5 Evaluation
The effectiveness of nursing interventions is evaluated by observing weight stability or gain, improved oral intake, reduced symptoms such as early satiety or nausea, and stable nutritional laboratory results, indicating effective management of nutritional imbalance in gastric cancer.
4.2.1 Assessment Findings
Patients who have undergone partial or total gastrectomy for gastric cancer are at high risk of dumping syndrome due to altered gastric anatomy and rapid gastric emptying, with assessment focusing on risk factors and early symptoms such as dizziness, palpitations, diaphoresis, abdominal cramping, nausea, diarrhoea, and post-meal fatigue or weakness.
4.2.2 Nursing Diagnosis Statement
Risk for dumping syndrome
Related to altered gastric emptying secondary to partial or total gastrectomy.
4.2.3 Goals and Expected Outcomes
Short-term goals:
Long-term goals:
4.2.4 Nursing Interventions and Rationales
| Nursing Interventions | Rationales |
| Assess the patient for early and late signs of dumping syndrome after meals. | Early identification allows prompt intervention and prevention of complications. |
| Advise the patient to consume small, frequent meals throughout the day. | Smaller meal volumes reduce rapid gastric emptying into the small intestine. |
| Instruct the patient to avoid consuming fluids during meals and to drink fluids between meals instead. | Separating fluids from meals slows intestinal transit and reduces osmotic shifts. |
| Encourage a diet high in protein and low in simple carbohydrates. | Protein delays gastric emptying, while simple sugars exacerbate dumping syndrome symptoms. |
| Position the patient in a semi-recumbent or supine position for 20–30 minutes after meals if indicated. | This position slows gastric emptying and reduces postprandial symptoms. |
| Provide education regarding symptom recognition and dietary self-management. | Patient education enhances adherence and long-term prevention of dumping syndrome. |
4.2.5 Evaluation
Evaluation focuses on the absence of dumping syndrome symptoms, stable postprandial vital signs, and the patient’s ability to follow recommended dietary modifications and verbalise effective prevention strategies.
4.3.1 Assessment Findings
Patients with gastric cancer may develop impaired gastrointestinal motility due to tumour obstruction or post-gastrectomy changes, presenting with nausea, vomiting, abdominal distension, early satiety, reduced oral intake, hypoactive bowel sounds, and post-meal discomfort, while severe cases may involve gastric outlet obstruction, projectile vomiting, and significant weight loss.
4.3.2 Nursing Diagnosis Statement
Impaired gastrointestinal motility
Related to mechanical obstruction and altered gastric structure secondary to a gastric tumour and surgical intervention, as evidenced by nausea, vomiting, abdominal distension, early satiety, and hypoactive bowel sounds.
4.3.3 Goals and Expected Outcomes
Short-term goals:
Long-term goals:
4.3.4 Nursing Interventions and Rationales
| Nursing Interventions | Rationales |
| Assess bowel sounds, abdominal distension, and frequency of nausea or vomiting regularly. | Ongoing assessment provides information on gastrointestinal motility and detects deterioration early. |
| Monitor the patient’s tolerance to oral intake and progression of diet. | Gradual dietary advancement prevents exacerbation of motility impairment. |
| Maintain the patient in an upright position during and after meals. | Upright positioning facilitates gastric emptying and reduces gastric stasis. |
| Administer prescribed prokinetic and antiemetic medications as ordered. | These medications enhance gastrointestinal motility and control nausea and vomiting. |
| Encourage early ambulation as tolerated. | Physical movement stimulates gastrointestinal peristalsis and improves motility. |
| Educate the patient on recognising symptoms of gastrointestinal obstruction or worsening motility. | Early reporting allows prompt medical intervention and prevents complications. |
4.3.5 Evaluation
Evaluation of nursing care focuses on improved gastrointestinal function, shown by reduced nausea and vomiting, decreased abdominal distension, normal bowel sounds, and better tolerance to oral intake, indicating effective management of impaired gastrointestinal motility in gastric cancer.
Evaluation is the final step of the nursing care process and involves determining whether nursing interventions have achieved the planned goals and outcomes. In patients with gastric cancer, continuous evaluation is important due to ongoing disease progression and treatment-related physiological changes, allowing nurses to assess patient progress, adjust care plans, and maintain quality care.
continuous evaluation is important due to ongoing disease progression and treatment-related physiological changes, allowing nurses to assess patient progress, adjust care plans, and maintain quality care.
5.1 Evaluation of Patient Outcomes
For patients with imbalanced nutrition, successful outcomes are shown by stable or increased body weight, improved tolerance to oral intake, better nutritional laboratory results, and adherence to dietary advice.
For patients at risk of dumping syndrome, effective nursing care is indicated by the absence of post-meal symptoms such as dizziness, diaphoresis, abdominal cramping, and diarrhoea, along with the patient’s ability to practise recommended eating habits.
For patients with impaired gastrointestinal motility, positive outcomes include reduced nausea and vomiting, decreased abdominal distension, normal bowel sounds, improved tolerance to oral intake, and no signs of obstruction or worsening motility.
The effectiveness of nursing interventions is evaluated by how well patient outcomes achieve the established goals. Continuous reassessment allows nurses to adjust care as needed, with multidisciplinary collaboration when goals are not met.
Overall, ongoing evaluation ensures that nursing care for patients with gastric cancer remains patient-centred and responsive, supporting symptom control, prevention of complications, and improved quality of life throughout the illness.
In conclusion, gastric cancer causes significant challenges to gastrointestinal function, nutrition, and overall well-being, requiring comprehensive and individualised nursing care, especially after surgical and oncological treatments.
The nursing care process offers a structured method for providing holistic and evidence-based care through proper assessment, accurate nursing diagnoses, appropriate interventions, and ongoing evaluation. By focusing on key nursing diagnoses such as imbalanced nutrition, risk for dumping syndrome, and impaired gastrointestinal motility, nurses can effectively manage problems related to gastric cancer and its treatment.
Overall, effective nursing management plays an important role in supporting recovery, preventing complications, improving quality of life, and caring for patients throughout the course of the illness.
Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2021).
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249.
https://doi.org/10.3322/caac.21660
Hinkle, J. L., & Cheever, K. H. (2022).
Brunner & Suddarth’s textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2023).
Medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier.
Macaire, G. (2023).
Nutrition care for patients with upper gastrointestinal malignancies: Part 2 – Gastric cancer. Practical Gastroenterology, 47(12), 28–36.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2021).
Fundamentals of nursing (10th ed.). Elsevier.
Rawla, P., & Barsouk, A. (2019).
Epidemiology of gastric cancer: Global trends, risk factors, and prevention. Przegląd Gastroenterologiczny, 14(1), 26–38.
https://doi.org/10.5114/pg.2018.80001
Rosania, R. (2016).
Nutrition in patients with gastric cancer: An update. Nutrition, 32(11–12), 1191–1196.
https://doi.org/10.1016/j.nut.2016.04.002
Scarpellini, E., Arts, J., Karamanolis, G., Laurenius, A., Siquini, W., Suzuki, H., Ukleja, A., & Tack, J. (2020).
International consensus on the diagnosis and management of dumping syndrome. Nature Reviews Gastroenterology & Hepatology, 17(8), 448–466.
https://doi.org/10.1038/s41575-020-0287-0
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2020).
Textbook of medical-surgical nursing (14th ed.). Wolters Kluwer.
Wang, H. M., Wang, T. J., Huang, C. S., Liang, S. Y., Yu, C. H., Lin, T. R., & Wu, K. F. (2022).
Nutritional status and related factors in patients with gastric cancer after gastrectomy: A cross-sectional study. Nutrients, 14(13), 2634.
https://doi.org/10.3390/nu14132634
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