Describe the pre operative care for patient following gastrectomy
Pre-operative care for a patient following gastrectomy involves a series of preparatory measures, assessments, and interventions to ensure the patient is in the optimal state for surgery. The specific type of gastrectomy performed (partial or total) and the underlying medical condition of the patient may influence the exact pre-operative care plan. However, the following are some common aspects of pre-operative care:
1. Pre-operative Assessment: Comprehensive assessment of the patient's medical history, physical examination, and laboratory investigations is conducted to identify any potential risks or contraindications for surgery. This includes evaluating the patient's cardiovascular, respiratory, renal, and hepatic function.
2. Nutritional Assessment: Given that gastrectomy involves the removal of a portion or the entire stomach, assessing the patient's nutritional status is crucial. Malnutrition is common in patients undergoing gastrectomy due to surgical changes in the digestive system. A nutritionist may be involved to assess the patient's dietary habits, caloric intake, and any specific nutritional deficiencies. If needed, pre-operative nutritional supplementation or dietary modifications are prescribed to optimize the patient's nutritional status.
3. Bowel Preparation: In some cases, patients may be required to undergo bowel preparation prior to gastrectomy. This involves the use of laxatives and enemas to cleanse the bowel, thus reducing the risk of contamination during surgery.
4. Medication Management: Current medications are reviewed, and the patient's primary healthcare provider may discontinue or modify certain medications that can interfere with anesthesia or increase the risk of bleeding, such as anticoagulants or non-steroidal anti-inflammatory drugs (NSAIDs). In some cases, prophylactic antibiotics may be prescribed to prevent surgical site infections.
5. Psychological Support and Education: Patients undergoing gastrectomy may experience anxiety or fear due to the implications of the surgery. Providing psychological support, explaining the procedure, and answering any questions or concerns can help alleviate the patient's anxiety. Education about the surgical procedure, post-operative expectations, and potential complications is also important to ensure that the patient is well-informed and prepared.
6. Pre-operative Fasting: Patients are instructed to abstain from eating or drinking for a specified period before surgery to minimize the risk of aspiration during anesthesia. The fasting period typically starts at midnight on the day before surgery, although this can vary depending on the institution's protocol.
7. Pre-operative Hydration: Adequate hydration is important for patients undergoing surgery to maintain optimal blood volume and improve surgical outcomes. Intravenous fluid hydration may be recommended before surgery, especially for patients at risk of dehydration or compromised fluid balance.
8. Respiratory Preparation: Patients are encouraged to practice deep breathing exercises and coughing techniques to enhance respiratory function and reduce the risk of post-operative complications, such as pneumonia.
9. Pre-operative Skin Preparation: The surgical site is prepared by cleaning the skin with an antiseptic solution to reduce the risk of surgical site infections.
10. Pre-operative Consent: Informed consent is obtained from the patient, or their legal representative, after fully explaining the risks, benefits, and alternatives of the gastrectomy procedure.
It is important to note that the pre-operative care plan for a patient following gastrectomy may vary depending on the healthcare facility, surgeon's preferences, and patient-specific needs and conditions. Thus, the above mentioned care plan should be considered as a general outline and may be customized as per individual requirements.