Subtotal gastrectomy or gastric resection is the removal of a portion of the stomach indicated for gastric hemorrhage/intractable ulcers, dysfunctional lower esophageal sphincter, pyloric obstruction, perforation, cancer. During subtotal gastrectomy, the surgeon removes only the portion of the stomach affected by cancer.
Nursing Care Plans
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
- Other Possible Nursing Care Plans
Risk for Imbalanced Nutrition: Less Than Body Requirements
- Imbalanced Nutrition: Less Than Body Requirements
Risk factors may include
- Restriction of fluids and food
- Change in digestive process/absorption of nutrients
Possibly evidenced by
- Not applicable for risk diagnosis. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.
- Maintain stable weight/demonstrate progressive weight gain toward the goal with normalization of laboratory values.
- Be free of signs of malnutrition.
|Maintain patency of NG tube. Notify the physician if the tube becomes dislodged.||Provides rest for GI tract during the acute postoperative phase until the return of normal function. Note: The physician or surgeon may need to reposition the tube endoscopically to prevent injury to the operative area.|
|Note character and amount of gastric drainage.||Will be bloody for first 12 hr, and then should clear and turn greenish. Continued or recurrent bleeding suggests complications. A decline in output may reflect the return of GI function.|
|Caution patient to limit the intake of ice chips.||Excessive intake of ice produces nausea and can wash out electrolytes via the NG tube.|
|Provide oral hygiene on a regular, frequent basis, including petroleum jelly for lips.||Prevents discomfort of dry mouth and cracked lips caused by fluid restriction and the NG tube.|
|Auscultate for resumption of bowel sounds and note passage of flatus.||Peristalsis can be expected to return about the third postoperative day, signaling readiness to resume oral intake.|
|Monitor tolerance to fluid and food intake, noting abdominal distension, reports of increased pain, cramping, nausea, and vomiting.||Complications of paralytic ileus, obstruction, delayed gastric emptying, and gastric dilation may occur, possibly requiring reinsertion of NG tube.|
|Avoid milk and high-carbohydrate foods in the diet.||May trigger dumping syndrome.|
|Note admission weight and compare with subsequent readings.||Provides information about the adequacy of dietary intake and determination of nutritional needs.|
|Administer IV fluids, TPN, and lipids as indicated.||Meets fluid and nutritional needs until oral intake can be resumed.|
|Monitor laboratory studies (Hb and Hct, electrolytes, and total protein, prealbumin).||Indicators of fluid and nutritional needs and effectiveness of therapy, and detects developing complications.|
|Progress diet as tolerated, advancing from clear liquid to bland diet with several small feedings.||Usually, the NG tube is clamped for specified periods of time when peristalsis returns to determine tolerance. After NG tube is removed, intake is advanced gradually to prevent gastric irritation and distension.|
|Administer medications as indicated:|
||Controls dumping syndrome, enhancing digestion and absorption of nutrients.|
||Removal of the stomach prevents absorption of vitamin B12 (owing to loss of intrinsic factor) and can lead to pernicious anemia. In addition, rapid emptying of the stomach reduces the absorption of calcium.|
||Corrects and prevents iron deficiency anemia.|
||Additional protein may be helpful for tissue repair and healing.|
||Enhances digestive process.|
||Promotes the absorption of fats and fat-soluble vitamins to prevent malabsorption problems.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans