The nurse is preparing a client who had a Roux-en-Y gastric bypass (RYGB) for discharge from the hospital. What information should the nurse plan to include related to the prevention of dumping syndrome?

Question

The nurse is preparing a client who had a Roux-en-Y gastric bypass (RYGB) for discharge from the hospital.  What information should the nurse plan to include related to the prevention of dumping syndrome?

Quizplus · Accepted Answer

11ecbb05_c9af_e159_b433_d12998b379aa_MD0009_00 An RYGB procedure uses a small proximal portion of the stomach to create a gastric pouch that is anastomosed to the Roux limb of the small intestine, bypassing most of the stomach and a portion of the duodenum. Dumping syndrome, the rapid emptying of gastric contents into the small intestine, is a potential complication. The presence of a large quantity of hyperosmolar intestinal contents causes fluids to shift out of the vascular system into the intestines, leading to symptoms such as nausea, vomiting, diarrhea, weakness, and hypotension. To prevent dumping syndrome, clients should eat multiple small meals, eat a low-carbohydrate diet, and separate their consumption of food and fluids (Option A). (Option B) Clients should be taught to consume food and fluids at least 30 minutes apart, and the health care provider may limit total daily fluid consumption. Limiting fluids decreases distension and feelings of fullness. (Option C) Iron-deficiency anemia is a common side effect after an RYGB as iron is absorbed in the duodenum and proximal jejunum. Taking supplements of iron and calcium can help with this problem but does not prevent dumping syndrome. (Option D) The smaller gastric pouch decreases the amount of intrinsic factor made by the parietal cells in the stomach, which may cause cobalamin deficiency. The client will need parenteral or intranasal cobalamin replacement; however, this will not prevent dumping syndrome. Educational objective: An RYGB (anastomosis of a small gastric pouch to the Roux limb of the small intestine) has several potential complications, including dumping syndrome, iron deficiency anemia, and cobalamin deficiency. To prevent dumping syndrome, the client should consume small meals, eat a low-carbohydrate diet, and consume food and fluids 30 minutes apart.

The Nurse Is Preparing a Client Who Had a Roux-En-Y