Overview
Gallbladder cancer is a malignant tumor of gallbladder, which ranks 5th to 6th among the digestive tract tumors in China, and is the most common among the malignant tumors of biliary tract. Early symptoms of gallbladder cancer are not obvious, resulting in most patients are in advanced stage once diagnosed, with poor prognosis. Rediscovery and management of existing or potential problems such as abdominal pain, nausea, vomiting, ascites, weight loss, jaundice, etc. in patients with gallbladder cancer are conducive to the improvement of patients’ quality of life and prognosis.
Main nursing problems
1. pain.
2. Nutritional disorders.
3. potential for skin breakdown due to itching.
4. potential complications such as anastomotic fistula, bleeding.
Nursing measures
1. Psychological care
Nursing staff should patiently and proactively introduce the methods and process of gallbladder cancer treatment to patients and their families, eliminate patients’ fear, tension and anxiety, and strengthen the confidence of overcoming the disease, so as to make patients actively cooperate with the treatment.
2. Pain care
For preoperative pain, the nature and degree of pain should be evaluated firstly, then analgesic drugs should be given according to doctor’s prescription, and the efficacy and adverse reaction of drugs should be observed. For postoperative pain, patients should be instructed to correctly use analgesic pumps or be given analgesics as prescribed by doctors.
3.Nutritional support nursing
(1) For those who can eat before surgery, patients can be given high-calorie, vitamin-rich, low-fat, easy-to-digest diets, and those with good liver function can be given high-protein diets. If the patients can not eat or eat too little, intravenous nutritional support can be given.
(2) Intravenous nutritional support should be given within 24 hours after operation. After gastrointestinal function is restored and exhaust gas is removed from the gastric tube, the patient can be gradually transitioned to fluids, semi-fluids, or general food, and the diet should be light and easy to be digested.
4.Drainage tube care
Patients are often placed with multiple drainage tubes (e.g. oxygen tube, gastric tube, urinary catheter, abdominal drainage tube, etc.) after surgery. After returning to the ward, all kinds of drainage devices should be connected and properly fixed to keep the drainage tubes unobstructed, and the amount, nature, and color of all kinds of drainage should be well labeled and recorded, and any detachment of drainage tubes should be handled in time.
5.Complications care
(1) anastomotic fistula often occurs 4-6 days after surgery, manifested as sudden severe pain in the right upper abdomen and signs of peritoneal irritation, should pay attention to the observation of the patient’s abdominal pain and changes in body temperature, once abnormal, should promptly notify the doctor.
(2) Bleeding After operation, closely observe the vital signs of the patient, if the patient has a drop in blood pressure, abdominal pain, bleeding fluid from the drainage tube, bleeding should be considered, and the doctor should be notified immediately for resuscitation.
6. Nursing care of chemotherapy
Closely observe the patient’s reaction after chemotherapy, for severe vomiting, diarrhea should follow the doctor’s instructions to be water electrolyte supplementation, regular rechecking of blood routine and so on. Immediately report the changes in condition to the doctor.
Health promotion
1. Adopt good dietary habits and eat small meals. Eat light, easy-to-digest food and less greasy food.
2. Take appropriate physical exercise and avoid exertion and exposure to cold.
3. Follow the doctor’s instructions for regular follow-up, and consult the doctor in time if symptoms such as abdominal pain, nausea, vomiting, and redness, swelling, heat and pain of the wound occur.