Page 1492 - Saunders Comprehensive Review For NCLEX-RN

e. Administer blood transfusions as
prescribed.
f. Prepare to assist with administering
medications as prescribed to induce
vasoconstriction and reduce bleeding.
6. Surgical interventions
a. Total gastrectomy: Removal of the
stomach with attachment of the
esophagus to the jejunum or
duodenum; also called
esophagojejunostomy or
esophagoduodenostomy
b. Vagotomy: Surgical division of the
vagus nerve to eliminate the vagal
impulses that stimulate hydrochloric
acid secretion in the stomach
c. Gastric resection: Removal of the lower
half of the stomach and usually
includes a vagotomy; also called
antrectomy
d. Gastroduodenostomy: Partial
gastrectomy, with the remaining
segment anastomosed to the
duodenum; also called Billroth I (Fig.
48-1)
e. Gastrojejunostomy: Partial gastrectomy,
with the remaining segment
anastomosed to the jejunum; also
called Billroth II (Fig. 48-2)
f. Pyloroplasty: Enlargement of the
pylorus to prevent or decrease pyloric
obstruction, thereby enhancing gastric
emptying
7. Postoperative interventions
a. Monitor vital signs.

b. Place in a Fowler’s position for

comfort and to promote drainage.
c. Administer fluids and electrolyte
replacements intravenously as
prescribed; monitor intake and output.
d. Assess bowel sounds.
e. Monitor NG suction as prescribed.
f. Maintain NPO status as prescribed for 1
to 3 days until peristalsis returns.
g. Progress the diet from NPO to sips of
clear water to 6 small bland meals a
day, as prescribed when bowel sounds

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