The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome?
A. Eat high-carbohydrate foods.
B. Limit the fluids taken with meals.
C. Ambulate following a meal.
D. Sit in a high-Fowler's position during meals.
Correct Answer: B. Limit the fluids taken with meals.
The nurse should instruct the client to decrease the amount of fluid taken at meals and to take antispasmodics as prescribed. Discuss the importance of eating small, frequent meals slowly and in a relaxed atmosphere; resting after meals; avoiding extremely hot or cold food; restricting high-fiber foods, caffeine, milk products, and alcohol, excess sugars and salt; and taking fluids between meals, rather than with food.
Option A: The nurse should instruct the client to avoid high carbohydrate foods including fluids such as fruit nectars. Review dietary needs and regimen (low-carbohydrate, low-fat, high-protein) and the importance of maintaining vitamin supplementation. This may prevent deficiencies, enhance healing, and promote cooperation with therapy. A low-fat diet may be required to reduce the risk of alkaline reflux gastritis.
Option C: The nurse should instruct the client to lie down for 30 minutes after eating to delay gastric emptying. Identify symptoms that may indicate dumping syndrome, (weakness, profuse perspiration, epigastric fullness, nausea and vomiting, abdominal cramping, faintness, flushing, explosive diarrhea, and palpitations occurring within 15 min to 1 hr after eating).
Option D: The nurse should instruct the client to assume a low Fowler’s position during meals. Avoid placing the patient in a supine position, have the patient sit upright after meals. Supine position after meals can increase regurgitation of acid. Instruct the patient to chew food thoroughly and eat slowly. Well-masticated food is easier to swallow. Food should be cut into small pieces.
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