A community health nurse is preparing for an initial home visit to a patient discharged following a total gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is most likely to include?
A) Enteral feeding via gastrostomy tube (G tube)
B) Gastrointestinal decompression by nasogastric tube
C) Periodic assessment for esophageal distension
D) Monthly administration of injections of vitamin B12
Ans: D
Feedback:
Since vitamin B12 is absorbed in the stomach, the patient requires vitamin B12 replacement to prevent pernicious anemia. A gastrectomy precludes the use of a G tube. Since the stomach is absent, a nasogastric tube would not be indicated. As well, this is not possible in the home setting. Since there is no stomach to act as a reservoir and fluids and nutrients are passing directly into the jejunum, distension is unlikely.
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