Question 1

Immediately following a gastrectomy.initial postoperative nutrition feedings are met by

Accepted Answer

Immediately following a gastrectomy.postoperative feedings usually are provided through a jejunostomy tube that provides elemental feedings.

Question 2

Advancing the carbohydrate load too quickly in total parenteral nutrition may result in

Accepted Answer

Advancing the carbohydrate load too quickly when administering total parenteral nutrition can result in hyperglycemia.

Question 3

Mr.B needs to have his gall bladder removed.His appetite has been poor.and he has lost 20 lb in the past 4 months.Before surgery he should

Accepted Answer

Mr.B's weight loss indicates that he has decreased his nutrient stores.This could impair his ability to heal after surgery.Prior to surgery.he should try to increase his intake of energy.protein.vitamins.and minerals to boost his nutrient stores.For example.he could eat six small meals each day.

Question 4

After a cholecystectomy.an example of a food item that may need to be decreased is

Accepted Answer

Depending on individual tolerance and response.a relatively low-fat diet may be needed.The gallbladder stores bile produced by the liver.which is secreted when fat enters the small intestine.After surgery.control of fat in the diet facilitates wound healing and comfort because the hormonal stimulus for bile secretion still functions in the surgical area.causing pain with intake of fatty foods.The body also needs a period to readjust to the more dilute supply of liver bile available to assist in fat digestion and absorption.

Question 5

For a patient who can take an oral diet.a food that would be a good source of energy during the postoperative period would be

Accepted Answer

During the postoperative period.the primary source of energy for the body should be carbohydrates supplied by cereals and other grains.

Question 6

Commercial enteral feeding formulas are preferred to blenderized food because they

Accepted Answer

Commercially prepared enteral feeding formulas provide a sterile.homogenized solution and are less likely to become contaminated with bacteria than blenderized food.

Question 7

Two minerals that are lost during tissue catabolism are

Accepted Answer

Potassium and phosphorus are lost during tissue catabolism.When tissue is broken down.cell potassium and phosphorus are lost from inside the cells.

Question 8

The food item most likely to lead to dumping syndrome is

Accepted Answer

The complex of symptoms in dumping syndrome constitutes a shock syndrome that results when a meal containing a large portion of readily soluble carbohydrates rapidly enters.or "dumps" into the small intestine.

Question 9

The most common nutritional deficiency among surgical patients is a deficiency of

Accepted Answer

Protein deficiencies among surgical patients are the most common.

Question 10

Patients who have had radical surgery of the head.neck.or throat may require

Accepted Answer

If regular oral feedings are not tolerated.the patient is severely debilitated.or has undergone radical neck or face surgery.tube feedings may be necessary.

Question 11

Fluid loss due to vomiting.fever.or excessive urination is accompanied by loss of the electrolytes

Accepted Answer

Because sodium is the major electrolyte in extracellular fluid.electrolyte losses will occur with water loss.Chloride losses also occur because it is also widely distributed within the extracellular compartment.

Question 12

Ms.Jones has recently had gastric surgery; 45 minutes after eating her regular diet she feels cramping and full with waves of weakness and dizziness.Ms.Jones is most likely experiencing

Accepted Answer

Dumping syndrome is a frequently encountered complication after extensive gastric resection.After the initial recovery from surgery when the patient begins to feel better and eats a regular diet in greater volume and variety.discomfort may occur 30 to 60 minutes after meals.A cramping and full feeling develops.the pulse becomes rapid.and a wave of weakness.cold sweating.and dizziness may follow.

Question 13

A good source of vitamin C.important during the healing process.is

Accepted Answer

Broccoli is a good source of vitamin C that is necessary to build and maintain strong tissues.especially connective tissues.

Question 14

Protein is especially needed in the postoperative recovery period for

Accepted Answer

Protein assists in the maintenance of osmotic pressure.which is necessary to maintain normal movement of fluid between the capillaries and surrounding tissue.Without maintenance of osmotic pressure.edema develops.

Question 15

If a patient requires parenteral nutrition for a prolonged period.the most appropriate type of feeding is

Accepted Answer

Total parenteral nutrition is indicated if the gastrointestinal tract cannot be used for a long period.Total parenteral nutrition.which supplies all the macronutrients and micronutrients along with fluid to meet daily requirements.is necessary for patients who need intravenous nutrition for an extended period.

Question 16

Before general surgery.nothing is given by mouth for at least

Accepted Answer

Nothing is given by mouth for at least 8 hours before surgery to avoid serious complications such as aspiration of stomach contents into the lungs.

Question 17

Once placed on an oral diet following a gastrectomy.an appropriate meal would consist of

Accepted Answer

After a gastrectomy.meals should be small.frequent.and easily digestible.such as scrambled eggs and toast.Liquids should be provided between meals rather than with meals.

Question 18

Blood losses may result in a deficiency of

Accepted Answer

Iron-deficiency anemia may result from blood loss or faulty iron absorption.

Question 19

An example of a food item that is usually not part of a regular oral diet is

Accepted Answer

Puréed carrots are not part of a regular oral diet because the texture has been modified.

Question 20

Physiologic symptoms of dumping syndrome result from

Accepted Answer

Dumping syndrome results when a meal containing a large portion of readily soluble carbohydrates rapidly enters.or "dumps," into the small intestine.This particular food mass is a concentrated solution in relation to the surrounding circulation of blood.To achieve an osmotic balance.water is drawn from the blood into the intestine.This water shift rapidly shrinks the vascular fluid volume.As a result.blood pressure drops and signs of rapid heart action to rebuild the blood volume appear.

Quiz 22: Surgery and Nutrition Support