. 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 D
Explanation
A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.
B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.
C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.
D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.
Correct Answer is ["A","C","E"]
Explanation
A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.
B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.
C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.
D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.
E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.
F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.