The nurse is providing discharge instructions to a male client following gastrectomy and instructs the client to take which measure to assist in preventing dumping syndrome?
A. Ambulate following a meal
B. Eat high carbohydrate foods
C. Limit the fluid taken with meal
D. Sit in a high-Fowler’s position during meals
Correct Answer: C. Limit the fluid taken with meals.
Dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after eating, especially following a Billroth II procedure. Early manifestations usually occur within 30 minutes of eating and include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the client to decrease the amount of fluid taken at meals.
Option A: The nurse should instruct the client to lie down for 30 minutes after eating to delay gastric emptying, and to take antispasmodics as prescribed. 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 B: 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 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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