. A patient who underwent gastric surgery is being educated on preventing dumping syndrome. Which of the following dietary recommendations should the nurse include in the teaching?
Consume small frequent meals throughout the day.
Lie down immediately after eating to aid digestion.
Include high-carbohydrate foods in every meal.
Drink fluids with meals to aid in digestion.
The Correct Answer is A
A. Consume small frequent meals throughout the day. Small, frequent meals reduce the volume of food entering the small intestine at one time, helping to prevent symptoms of dumping syndrome.
B. Lie down immediately after eating to aid digestion. Although lying down after eating can slow gastric emptying and help prevent dumping syndrome, it does not aid in digestion.
C. Include high-carbohydrate foods in every meal. High-carbohydrate foods are likely to worsen symptoms of dumping syndrome by causing rapid glucose absorption, which leads to a spike in insulin and subsequent hypoglycemia.
D. Drink fluids with meals to aid in digestion. Fluids should be taken between meals rather than with meals to avoid rapid gastric emptying and prevent dumping syndrome.
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Correct Answer is C
Explanation
A. "I should monitor my temperature regularly and report any fevers to my healthcare provider." This statement shows correct understanding. Fever may indicate worsening infection or complications, so it’s important to monitor and report any fevers.
B. "I need to inform my healthcare provider about any new symptoms, such as shortness of breath or chest pain." This statement shows understanding. New symptoms, especially respiratory or cardiac, could signify complications, and should be reported.
C. "I can stop taking my antibiotics once I feel better." This indicates a need for further teaching. Completing the full course of antibiotics is crucial to ensure the infection is completely eradicated, even if symptoms improve.
D. "I will need to take antibiotics before dental procedures." Patients with infective endocarditis often require prophylactic antibiotics before dental procedures to prevent bacterial entry into the bloodstream.
Correct Answer is B
Explanation
A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys. Reduced blood flow to the kidneys, or renal hypoperfusion, decreases the glomerular filtration rate (GFR) because less blood is being filtered through the kidneys. This can occur in conditions such as shock, severe dehydration, or heart failure, but it is not the primary mechanism in acute tubular necrosis (ATN).
B. The glomerular filtration rate decreases because there is injury to the renal tubular cells. In ATN, the injury to renal tubular cells impairs their function, leading to reduced reabsorption and filtration ability, which contributes to the decrease in GFR.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys. While inflammation may be present, it is not the primary cause of decreased GFR in acute tubular necrosis; reduced blood flow and tubular cell injury are more direct causes.
D. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down. Obstruction is not typically a characteristic of acute tubular necrosis; ATN is usually caused by ischemic or toxic injury, not physical obstruction.