Nursing Approach to the Client with Neoplastic process of the GI tract

Nursing Assessment

1. Assess for personal and family history, presence of previous GI damage, age, occupation, presence of other neoplastic changes, diet and nutritional habits, usage of certain medications.
2. Collect information of complaints that brought client to the hospital (dysphagia, pain or cramps, abdominal flatulence, food intolerance, nausea, vomiting, bowel disturbances, weakness, fever, appetite changes, weight loss, GI hemorrhage, etc.) .
3. Obtain history of onset and progression of symptoms.
4. Obtain information of signs of neoplastic changes in GI system.
5. Perform complete physical assessment including vital signs, signs of dehydration, jaundice, bowel dysfunction, body weight, GI bleeding, abdomen palpation, nausea and vomiting.
6. Assess diagnostic tests and procedures for abnormal values of GI system function.

Nursing Diagnosis

1. Increased risk of dehydration and electrolytes and metabolic disturbances due to GI dysfunction, related to neoplasm.
2. Intolerance to certain kinds of foods, body weight loss and cachexia, related to diagnosis of GI tract malignancy.
3. Increased risk of aspirations due to vomiting, caused by neoplastic process and its treatments.
4. Increased risk of GI bleeding, anemia and secondary infections, related to malignant process and its treatments.
5. Pain and restlessness, related to diagnosis of malignant process.
6. Changes in bowel habits, related to diagnosis.
7. Anxiety and fear, related to the symptoms of disease and diagnosis of neoplastic process.

Nursing Plan and Interventions

Goals

1. Increase comfort and rest, decrease pain.
2. Promote adequate nutrition and fluid intake, stabilize body weight if possible.
3. Prevent electrolytes and metabolic disturbances.
4. Prevent avoidable injury due to disease and treatments.
5. Then radio- or chemotherapy indicated, prevent possible complications.
6. Then surgical intervention prescribed, prevent postoperative complications.
7. Relief or diminish symptoms.
8. Decreased anxiety with increased knowledge of disease, it treatment, and needs of follow-up, assist I developing effective coping mechanisms.

Interventions

1. Assess, report , and record signs and symptoms and reactions to treatment.
2. Monitor fluids input and output closely.
3. Assess pain and discomfort daily and report immediately.
4. Administer medications as prescribed, monitor for side effects.
5. Monitor client’s vital signs and body weight changes closely.
6. Monitor possible GI hemorrhage, nausea and vomiting, report immediately and take measures for prevention.
7. Monitor client’s laboratory tests results for abnormal values.
8. Provide prescribed diet, use NG tube or gastrostomy tube if prescribed.
9. Administer IV therapy and blood transfusions as prescribed.
10. Provide teaching of client and his family about prescribed treatments and its possible complications, and methods of prevention.
11. Prepare client and his family for surgical intervention if required.
12. For client requires surgical intervention provide postoperative care and teach about possible postoperative complications and prevention measures.
13. Provide teaching of the client and the family prescribed procedures at home if required.
14. Provide emotional support to client and his family, explain all procedures to decrease anxiety and to obtain cooperation, assist to develop effective coping mechanisms.
15. Instruct client regarding disease progress, diagnostic procedures, treatment and its complications, home care, daily activities, diet, restrictions and follow-up.

Evaluation

1. Reports increased comfort, decreased anxiety.
2. Verbalizes sufficient pain control, absence of nausea and vomiting.
3. Maintains compliance with diet.
4. Maintains stable vital signs, fluid and metabolic balance, and sufficient nutritional state.
5. Laboratory tests results shows no abnormalities.
6. No avoidable postoperative or treatments complications.
7. Maintain sufficient daily physical activity.
8. Developed effective coping mechanisms, able to make informed decisions about care.
9. Demonstration of understanding of disease progress, diagnostic and treatment procedures, complications, their prevention, and need for follow-up.
This information has been published by the International Biopharmaceutical Association www.ibpassociation.org . Please note this information does not give any medical advice.

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