C.H. is a very active 64-year-old white woman. She volunteers several days a week at the local senior center. She has recently developed increasing abdominal pain, accompanied by a 25-pound weight loss. A magnetic resonance image (MRI) scan showed a large mass in the fundal area of the stomach. A subtotal gastrectomy was performed. She is now day 1 into her postoperative recovery.

Introduction

Postoperative recovery is a critical phase for patients undergoing surgery, and it requires close monitoring and appropriate interventions to ensure optimum outcomes. This case study focuses on C.H., a 64-year-old woman who underwent a subtotal gastrectomy and is currently in day 1 of her postoperative recovery.

Subtotal Gastrectomy Procedure

A subtotal gastrectomy is a surgical procedure that involves the removal of a part of the stomach, usually the lower portion or fundus. It is commonly performed to treat conditions such as gastric cancer or severe peptic ulcers that do not respond to medication.

In C.H.’s case, the large mass found in the fundal area of her stomach led to the decision for a subtotal gastrectomy. During the procedure, the surgeon removes a portion of the stomach, preserving the remaining part to maintain digestive function.

Postoperative Recovery

Postoperative recovery refers to the period following surgery, during which the patient’s body undergoes healing and functional recovery. Several factors influence the length and complexity of the recovery process, including the patient’s overall health, the complexity of the surgery, and any complications that may arise.

During this initial phase of recovery, it is crucial to closely monitor the patient for any signs of complications, manage pain, promote wound healing, prevent infections, and restore bowel function. The healthcare team plays a pivotal role in providing appropriate interventions and support to ensure a smooth recovery.

Monitoring and Complication Detection

Monitoring the patient’s vital signs, such as blood pressure, heart rate, respiratory rate, and temperature, is essential during the postoperative recovery phase. Any significant changes in these vital signs may indicate complications such as bleeding, infection, or fluid imbalance.

In addition to vital signs, it is important to assess the patient’s pain level regularly. Managing pain effectively is crucial to promote patient comfort and prevent complications associated with inadequate pain control.

Wound care is another crucial aspect of postoperative recovery. The surgical incision site should be closely monitored for signs of infection, such as redness, swelling, discharge, or increased pain. Proper wound care techniques, including sterile dressing changes, may be necessary to prevent infection and promote healing.

Restoring Bowel Function

The recovery of bowel function is a vital component of postoperative care. After surgery, the patient’s bowel movements may be delayed due to the effects of anesthesia, reduced gastrointestinal activity, or the direct impact of surgery on the digestive system. Strategies to promote bowel function may include early ambulation, dietary modifications, and the use of medications such as laxatives or stool softeners.

It is crucial to monitor the patient’s bowel movements and assess for any signs of bowel obstruction or complications. Early intervention in the management of constipation or other bowel-related issues can prevent further complications and promote recovery.

Fluid and Nutritional Support

Maintaining adequate hydration and providing proper nutrition are essential during the postoperative recovery phase. In C.H.’s case, it is especially important because she had experienced significant weight loss prior to the surgery.

In the immediate postoperative period, intravenous fluids may be administered to maintain hydration until the patient is able to tolerate oral intake. The patient’s fluid balance should be monitored closely, as excessive fluid retention or depletion can lead to complications.

Once the patient is able to tolerate oral intake, a carefully planned and balanced diet is crucial to provide adequate nutrients and support healing. Depending on the extent of C.H.’s gastrectomy, she may require dietary modifications to ensure optimal digestive function and nutrient absorption.

Conclusion

In conclusion, C.H.’s postoperative recovery following a subtotal gastrectomy requires close monitoring and appropriate interventions to ensure a smooth and successful recovery. The healthcare team must carefully assess vital signs, manage pain, monitor wounds, restore bowel function, and provide fluid and nutritional support. By implementing these strategies, C.H.’s postoperative recovery can be optimized, leading to improved patient outcomes.