Editing Nutrition – RN Practice Questions (section)

==Question 10==
A client who had a subtotal gastrectomy reports dizziness, palpitations, diaphoresis, and abdominal cramping about 20 minutes after eating. Which dietary instructions should the nurse reinforce? '''Select all that apply.'''
# Eat six small meals per day rather than three large ones.
# Drink 8 ounces of fluid with each meal to aid digestion.
# Increase intake of protein and reduce simple sugars.
# Lie down or recline for 20 to 30 minutes after eating.
# Choose high-carbohydrate foods such as fruit juice and sweetened cereal.

'''Answer:''' 1, 3, and 4.

''Rationale:'' These symptoms describe early dumping syndrome, in which a hyperosmolar bolus enters the jejunum rapidly and pulls fluid into the bowel lumen, causing intravascular volume shift and vasomotor symptoms. Management slows gastric emptying: small frequent meals, higher protein and moderate fat, low simple carbohydrate, and reclining after meals to slow transit by gravity. Option 2 is wrong because fluids taken with meals accelerate gastric emptying; fluids are taken between meals, roughly 30 to 60 minutes before or after. Option 5 is wrong because simple sugars are the primary osmotic trigger and would worsen symptoms and increase the risk of late dumping hypoglycemia.