A patient who had gastric bypass surgery 5 weeks ago calls the ...

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A patient who had gastric bypass surgery 5 weeks ago calls the office to report feelings of nausea, sweating, and diarrhea shortly after eating meals. What response by the nurse is most appropriate?
 
  a. This is common after the type of surgery you had.
  b. How much, if any, alcohol do you con-sume each day?
  c. Avoid large meals, limit sweets, and drink small amounts of liquids between meals.
  d. You may be experiencing a postoperative infection.

Question 2

The nurse is caring for a patient who is being treated for a gunshot wound to the abdomen. The patient is receiving total parenteral nutrition (TPN), and the physician has prescribed insulin coverage on a sliding scale.
 
  The patient reports he has never had diabetes before. What response is best for the nurse to make?
  a. It is likely you have developed diabetes as a result of your illness.
  b. Do you have a family history for di-abetes?
  c. The TPN you are receiving has high amounts of glucose.
  d. Insulin is needed to manage your sto-mach's inability to adequately metabolize food at this time.

[AISCAMPING]

Answer to Question 1

C
Some patients who have had a gastrectomy experience a complication known as the dumping syndrome. The patient has nausea, weakness, abdominal pain, and diarrhea and may feel faint and perspire profusely or experience palpitations after eating. These sensations are caused by the rapid passage of large amounts of food and liquid into the jejunum. When a patient experiences dumping syndrome, instruction is given to avoid eating large meals and to drink a minimum of fluids during the meal. Fluids may be taken in small amounts later, between meals. If sweet foods seem to aggravate the conditionand they sometimes dothe patient should try to avoid them. Although this is not an uncommon manifestation after this type of surgery, informing the patient that this is common provides limited information to the patient and is not the best re-sponse. This problem is not connected to alcohol consumption and is not a symptom of a post-operative infection.

Answer to Question 2

C
People on TPN are prone to hyperglycemia from the high glucose content of the solution.