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Faculty of Nursing
2nd term Master
2014
"Gastric Cancer"
Objectives
At the end of this case study, I will be able to:
General objectives:
To provide the patient with high quality of care based on
accurate assessment & scientific knowledge.
Specific objectives:
1. To perform patient assessment.
2. To acquire knowledge about disease process and its
complication.
3. Epidemiology.
4. Overview one the anatomy and physiology of the affected system.
5. Patient Demographic data.
6. Past and present Medical history of current illness.
7. Comparison between patient disease, which already clinically
present and what in the textbook.
Including The high-risk group and age.
Common site.
Predisposing factors (Causes).
Patho physiology.
Clinical Manifestations.
The Diagnostic Evaluations.
Diagnostic procedures.
Laboratory Investigations.
The complications.
The Management.
Medical Management.
Surgical Management.
Nursing Management.
6) Comprehensive Nursing care plan for the patient for already
clinically existed Health problems.
7) Rehabilitation program for this patient.
Reasons for patient selections: The patient case was critical, reached to a serious complicated
late stage of disease "Cancer stages" and He Needs for
comprehensive Nursing care more than other patient was.
I am interested in this patient's Diagnosis studying and
making a correlation between the textbook and what really
with the patient case.
The affected system "Digestive system "stomach" is more
sensitive human body part Need for specific consideration.
Introduction:
95% of gastric cancers are adenocarcinomas.
The remaining 5% are lymphomas (second most common, includes
MALT
lymphomas), sarcomas (including leiomyosarcomas and Kaposis
sarcomas),
GISTs, carcinoids, and squamous cell carcinomas
2 distinct histologic subtypes of gastric adenocarcinomas: intestinal,
diffuse
Epidemiology
Worldwide: fourth most common cancer, 2nd leading cause of
cancer death
In the US: 14th most common cancer, 7th most common cancer
death
Incidence of intestinal type has declined rapidly over the recent few
Decades? Due to invention of refrigerators, with better food storage
and
Reduced need for salt-based preservation.
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Sex: Male.
Education :Illiterate
Religious: Muslim
Occupation: farmer
Marital status: Married and has three siblings (2 sons and
daughter).
Date of admission: 10/4/2014.
Admitted from: outpatient department (OPD).
Stay period: 15 day.
Prsent History :
From 2 years ago the patient felt with sever pain in the left leg
combined e pale to white color of extremities and very weak
peripheral pulse on this limb.
CT angiography was made for the patient left limb, which was
revealed with thrombotic occlusion of left external iliac / left
common femoral artery.
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He has No familial
History of cancer.
There is No validated
Gastric cancer has high
incidence with patient has familial check up for genetic liability
or Not.
history of GI.T cancers
Alternatively, who has genetic
liability as Mutation of "Tumor
suppressor gene"?
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Helico-bacterial Infection.
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Dyspepsia (Indigestion).
Anorexia e early satiety.
Weight loss.
Loss of appetite.
cachexia
Chronic constipation.
Anemia.
Palpable gastric Mass.
Malaise and easily
fatigability.
Drowsiness.
Dyspnea.
Agitation and irritability.
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(C)* Laboratory
Investigations:-
Investigation
WBC
Results
710^9/L
Tumor Markers as
RBC
3.510^12/
L
9.5g/dl
HG
Carbohydrate antigen.
C.B.C
Liver function and Renal
function.
Coagulation profile.
Arterial Blood gases.
Electrolytes Investigation.
PLATELETS 25910^9/
L
LDL
93mg/dl
SGPT
45U/L
SGOT
54U/L
PT
PTT
Bilirubin
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13.60
28.4
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* The pt developed
Metastasis to the liver
"hepatic focal lesion"
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Cisplatin "platinol"
Adriamycin.
Etopophos.
Mutamycin.
Radiotherapy: - mainly used as
palliation for pt with obstruction,
sever bleeding, sever pain
secondary to tumor.
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