Case Study
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
-After performing a nutritional assessment on ML, the registered dietitian determines that he is at risk for what nutritional complication after surgery?

Question

Case Study
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7"       Weight: 198#        UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
-After performing a nutritional assessment on ML, the registered dietitian determines that he is at risk for what nutritional complication after surgery?

Quizplus · Accepted Answer

Delayed gastric emptying is a common nutritional complication after the Whipple procedure. The procedure involves removing a significant portion of the pancreas, duodenum, gallbladder, and sometimes a portion of the stomach. This can result in delayed gastric emptying and malabsorption of nutrients. The NPO diet order is likely to continue until bowel function returns to normal. Scar tissue obstructing the duodenum is a risk after surgery, but it is not a nutritional complication. Complications with wound healing and return of cancer are also possible, but delayed gastric emptying is the most likely nutritional complication in this case. Delayed gastric emptying, also known as gastroparesis, is a common complication after the Whipple procedure. This is because the surgery can damage the nerves that control the stomach, leading to slower digestion and movement of food through the digestive tract. This can cause nausea, vomiting, feeling full quickly, and weight loss. Nutritional interventions, such as smaller, more frequent meals, and avoiding high-fat or high-fiber foods, can help manage this complication. Scar tissue obstructing the duodenum is a potential complication of surgery, but it is not specifically related to nutritional status. Complications with wound healing may also occur, but this is not the primary concern after the Whipple procedure. The return of cancer is a risk after any cancer treatment, but nutritional status is not directly related to cancer recurrence.

Case Study ML Is 55-Year-Old White Male with Prior Medical Hx of Hx