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

Explanation

A. Trochanter roll. This device is used to prevent external rotation of the hips, especially in clients who are immobile or lying supine. It does not support the feet or ankles and does not prevent plantar flexion.
B. Abduction pillow. An abduction pillow is placed between the legs to maintain proper hip alignment, particularly after hip surgery. It is not designed to prevent foot drop or plantar flexion contractures.
C. Sheepskin heel pad. This provides skin protection and pressure relief to prevent pressure ulcers on the heels. While useful for comfort and skin integrity, it does not keep the foot in a neutral position to prevent contractures.
D. Footboard. A footboard is placed at the foot of the bed to help maintain the foot in dorsiflexion, thereby preventing plantar flexion contractures (also known as foot drop). It supports proper alignment and is the most appropriate device for this purpose in clients with limited mobility.

A. Platelet count B. OPIT C. Fibrinogen level D. INR

Correct Answer is D

Explanation

A. Platelet count. While important for evaluating bleeding risk, platelet count is not directly used to adjust or determine daily warfarin dosing. Warfarin affects the coagulation cascade, not platelet function.
B. aPTT. The activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin. It assesses the intrinsic pathway of coagulation and is not sensitive to warfarin’s effects on the clotting factors.
C. Fibrinogen level. Fibrinogen is involved in clot formation, but its measurement is not part of routine warfarin management. It is more relevant in evaluating bleeding disorders or disseminated intravascular coagulation (DIC).
D. INR. The international normalized ratio (INR) is the primary lab value used to monitor the effectiveness and safety of warfarin therapy. It helps guide daily dosing by reflecting how long it takes blood to clot, with therapeutic ranges typically between 2.0 and 3.0 for most conditions.

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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.

Nursing Test Bank

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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.