Case study of a tongue cancer patient with nutritional deficit and nausea at RSUP dr. Sardjito

Abstract

Background: Squamous cell carcinoma (SCC) of the tongue is an oral malignancy that significantly affects
patients' quality of life, particularly in terms of eating and speaking. Side effects of chemotherapy, such as
recurrent nausea and vomiting, often lead to decreased food intake and increase the risk of nutritional deficits.
Enteral nutrition via a nasogastric tube (NGT) is frequently required; however, the commonly used bolus method
may worsen nausea and lead to feeding intolerance. Objective: To determine the effectiveness of the gravity drip
technique in reducing nausea and vomiting in patients with tongue cancer undergoing chemotherapy who require
NGT feeding. Method: This study used a case study approach within a comprehensive nursing care process,
including assessment, diagnosis, planning, implementation, and evaluation, conducted over three consecutive days
at Indraprastha 1 of RSUP Dr. Sardjito. Case: Mr. I, a 63-year-old male diagnosed with postoperative SCC of the
tongue and currently undergoing chemotherapy, experienced severe nausea and vomiting 4–5 times per day, along
with signs of nutritional deficit (BMI 16.8 kg/m²). Enteral nutrition was administered using the gravity drip
method. Results: After three days of intervention, vomiting frequency decreased to zero from the second day, and
nausea intensity reduced from severe to mild. The patients reported increased comfort and improved tolerance of
nutritional intake. Conclusion: The gravity drip technique proved effective in reducing nausea and vomiting and
in enhancing nutritional intake tolerance. Recommendation: Nurses are encouraged to consider gravity drip as a
more comfortable and tolerable alternative for enteral nutrition administration in NGT-fed patients undergoing
chemotherapy.