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ABSTRAK
Latar Belakang: Malnutrisi terjadi pada 80 karsinoma gaster. Pasien kanker yang menjalani pembedahan memerlukan dukungan nutrisi perioperatif dengan tujuan meningkatkan status gizi, mengurangi sensitivitas insulin dan menurunkan proses katabolisme. Metode: Pasien serial kasus adalah perempuan dengan rentang usia 28-74 tahun dengan diagnosis karsinoma gaster stadium lanjut. Terapi medik gizi prabedah diberikan dalam bentuk nutrisi oral dan enteral untuk mendukung kecukupan status gizi. Enam jam menjelang pembedahan, tiga pasien mendapatkan nutrisi parenteral formula glukosa asam amino dengan kandungan 15 g protein dan 37,5 g asam amino, sedangkan satu pasien dengan penyakit penyerta diabetes melitus tipe 2 mendapatkan nutrisi berupa cairan glukosa 50 g. Hasil: Pasien diberikan nutrisi enteral dini 2-30 jam pascabedah gastrektomi disertai dengan dukungan nutrisi parenteral. Hanya satu pasien mengalami kenaikan glukosa darah pascabedah hari pertama, namun glukosa darah terkontrol dengan pemberian insulin. Klinis dan penyembuhan luka pascabedah baik, pasien mendapatkan nutrisi oral pada 3 ndash; 7 hari pascabedah. Kesimpulan: Terapi medik gizi perioperatif pada karsinoma gaster memberikan hasil yang baik pada outcome bedah.

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ABSTRACT<>br> Objective Almost 80 gastric carcinoma patients was malnourished. Perioperative nutrition aims to support nutrition status, reduce insulin resistance and lower hypercatabolic state. Methods Four patients in this case series were female, age ranged 28-74 years with end stage gastric carcinoma. Preoperative nutrition was given by oral and enteral to support nutrition status. Six hours prior to surgery, patients were given preoperative nutrition glucose amino acid formula in three patients and dextrose formula in one patient. Glucose amino acid formula contains 15 g protein and 37,5 g amino acid, while dextrose formula contains 50 g glucose. Results All of patients have early enteral nutrition within 2 ndash 30 hours postoperative. Only one patient have risen blood glucose level, but had been controlled by administer insulin. Postoperative wound healing were good, the patients have oral nutrition within 3 ndash 7 days postoperative. Conclusion Perioperative nutrition supports good clinical outcomes in gastric carcinoma patients.

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Analisis praktik residensi merupakan laporan rangkaian kegiatan Ners Spesialis Keperawatan Medikal Bedah dengan penerapan Model Adaptasi Roy pada proses asuhan keperawatan pasien gangguan sistem pencernaan, penerapan praktik keperawatan berdasarkan evidence based serta melakukan inovasi keperawatan. Pengkajian kasus utama terhadap pasien karsinoma gaster dan 30 kasus resume pasien bedah digestif, gastrointestinal serta hepatobilier berfokus pada respon adaptif dari model adaptasi Roy. Pelaksanaan evidence based dilakukan untuk mengelola kecemasan pasien sebelum menjalani operasi bedah digestif sebanyak 8 orang, dengan intervensi mendengarkan Al-Qur`an Surah Al Waqi’ah dan terjemahannya selama 30 menit. Program inovasi keperawatan dilakukan, terhadap 7 orang pasien yang direncanakan menjalani operasi kolostomi berupa optimalisasi pemberian edukasi melalui media video. Kesimpulan: mendengarkan Al-Qur`an Surah Al Waqi’ah dan terjemahannya dapat menurunkan tingkat kecemasan pasien sebelum operasi dan edukasi melalui media video terhadap pasien yang akan menjalani operasi kolostomi dapat meningkatkan pengetahuan pasien yang sangat memengaruhi terhadap keputusan persetujuan pasien menjalani operasi. ......The residency practice analysis is a series of reports on the activities of Surgical Medical Nursing Specialists with the application of Roy's Adaptation Model in the nursing care process of patients with digestive system disorders, the application of evidence-based nursing practices and nursing innovations. Major case studies of gastric carcinoma patients and 30 cases of digestive, gastrointestinal and hepatobiliary surgery resumes focused on the adaptive response of Roy's adaptation model. Evidence based implementation was carried out to manage the anxiety of patients before undergoing digestive surgery as many as 8 people, with the intervention of listening to Al-Qur'an Surah Al Waqi'ah and its translation for 30 minutes. Nursing innovation program carried out, for 7 patients who were planned to undergo colostomy surgery in the form of optimizing the provision of education through video media. Conclusion: listening to Al-Qur'an Surah Al Waqi'ah and its translation can reduce the level of patient anxiety before surgery and education through video media for patients who will undergo colostomy surgery can increase patient knowledge which greatly influences the decision of consent for patients undergoing surgery.