A 50-year-old woman who underwent restrictive/malabsorptive ...

[Kikoku]

A 50-year-old woman who underwent restrictive/malabsorptive surgery with a biliopancreatic diversion about one year earlier demonstrated a distinct attitude change from previous visits when she arrived at the clinic.
 
  Instead of being friendly, she was argumentative with staff and other patients. The nurse reviewed her history and found that she had stopped taking the vitamin and mineral supplements prescribed post surgery. She suspected that the problem was caused by: 1. Vitamin B-3 deficiency that resulted in Pellagra.
   2. Vitamin B-6 deficiency that resulted in increased stress.
   3. Vitamin D deficiency that results in bone demineralization.
   4. Vitamin C deficiency that resulted in wet beri beri.

Question 2

Close monitoring of bone mineral density should be a priority for the nurse practitioner following bariatric surgery because:
 
  1. Clients are advised to avoid milk and milk products after surgery.
   2. Vitamin D is only absorbed in the stomach, not in the lower jejunum.
   3. Metabolic bone disease is more likely in clients who lose weight rapidly.
   4. Low levels of vitamin B12 cause bones to lose density.

[nicoleclaire22]

Answer to Question 1

1

Rationale: Restrictive surgery can decrease absorption of vitamins and minerals in the diet including niacin, the cause of Pellagra. Although vitamins B-6, D, and C are essential components of a balanced nutritional intake, deficiencies will not result in changes of the client's emotional status.

Answer to Question 2

3

Rationale: Clients follow a low-fat diet after surgery but are allowed to eat smaller portions of all food groups. Nutrients, including vitamins and minerals, are absorbed in the intestines not the stomach. Metabolic bone disease is more likely to occur with rapid weight loss since stores prior to surgery are sequestered in adipose tissue and not readily available in the body. Vitamin B12 does not contribute to bone mineral density.

[Kikoku]

Thanks

[nicoleclaire22]

Welcome