A nurse is caring for a male client who is postoperative.

Exhibits

Which of the following client findings should the nurse identify as being consistent with dumping syndrome? Select all that apply.

Vital signs

Prescribed diet

Skin appearance

Blood glucose level

WBC count

Answer and Explanation

Correct Answer : A,C,D

A. Vital signs. The client has a significantly elevated heart rate (110/min) and elevated blood pressure (178/82 mm Hg), both of which can be associated with autonomic responses in dumping syndrome. The dizziness and desire to lie down after eating are also classic symptoms. These signs reflect the body’s reaction to rapid gastric emptying and fluid shifts.
B. Prescribed diet. While a bland, soft diet is generally safe post-gastrectomy, it may not prevent dumping syndrome unless it includes specific modifications like low carbohydrate intake and small, frequent meals. However, this option alone does not directly indicate dumping syndrome.
C. Skin appearance. The client is noted to be diaphoretic and pale, which are common symptoms of dumping syndrome due to the vasomotor response and hypoglycemia that can follow rapid gastric emptying.
D. Blood glucose level. The client's fasting blood glucose dropped to 65 mg/dL, which is below the normal range. Hypoglycemia is a hallmark of late dumping syndrome, resulting from excessive insulin release after rapid carbohydrate absorption in the small intestine.
E. WBC count. The WBC count is within normal range (9,000/mm³) and does not indicate dumping syndrome or an infectious process. It is not relevant in this context.

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Correct Answer is ["D","E"]

Explanation

A. Ensure the formula is cold before administration. Enteral formula should be given at room temperature to avoid causing gastrointestinal cramping or discomfort. Cold formula can irritate the GI tract and lead to intolerance.
B. Check placement of the feeding tube by x-ray once daily. An x-ray is used initially to confirm tube placement after insertion, but daily x-rays are not required. Ongoing checks are done through aspirate checks and measuring external tube length.
C. Maintain the head of the client's bed at a 20° angle or higher. The head of the bed should be elevated to at least 30 to 45 degrees to prevent aspiration. A 20° angle is insufficient and increases the risk of aspiration pneumonia.
D. Check gastric residuals every 4 hr. This is appropriate for clients receiving continuous feedings. Monitoring gastric residual volume (GRV) every 4 hours helps assess tolerance to the feeding and reduces the risk of aspiration.
E. Change the feeding container and tubing every 24 hr. To prevent bacterial contamination, the feeding bag and tubing should be changed every 24 hours when using an open system. This is a standard infection control practice.

A. "Rise slowly when getting out of bed " B. “Taking furosemide can cause you to be overhydrated." C. "Eat foods that are high in sodium." D. “Taking furosemide can cause your potassium levels to be high."

Correct Answer is A

Explanation

A. "Rise slowly when getting out of bed." Furosemide can lead to significant fluid and electrolyte loss, causing orthostatic hypotension. Clients may experience dizziness or lightheadedness when changing positions. Rising slowly helps prevent falls and promotes safety.
B. “Taking furosemide can cause you to be overhydrated." Furosemide is a potent diuretic that promotes fluid excretion, not retention. The risk of dehydration and electrolyte imbalance is much higher than overhydration. Monitoring intake and output is essential.
C. "Eat foods that are high in sodium." High sodium intake increases fluid retention, which can worsen heart failure symptoms. Furosemide is often prescribed to manage fluid overload, and sodium-rich foods would counteract its effects. A low-sodium diet is recommended.
D. “Taking furosemide can cause your potassium levels to be high." Furosemide increases the excretion of potassium through the kidneys, often leading to hypokalemia. Low potassium levels can result in muscle weakness or cardiac arrhythmias.

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A nurse is caring for a male client who is postoperative. Exhibits Which of the following client findings should the nurse identify as being consistent with dumping syndrome? Select all that apply.

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A nurse is caring for a male client who is postoperative.

Exhibits

Which of the following client findings should the nurse identify as being consistent with dumping syndrome? Select all that apply.