A nurse is caring for a male client who is postoperative.
Which of the following client findings should the nurse identify as being consistent with dumping syndrome? Select all that apply.
Vital signs
Prescribed diet
Skin appearance
Blood glucose level
WBC count
Correct Answer : A,C,D
A. Vital signs. The client has a significantly elevated heart rate (110/min) and elevated blood pressure (178/82 mm Hg), both of which can be associated with autonomic responses in dumping syndrome. The dizziness and desire to lie down after eating are also classic symptoms. These signs reflect the body’s reaction to rapid gastric emptying and fluid shifts.
B. Prescribed diet. While a bland, soft diet is generally safe post-gastrectomy, it may not prevent dumping syndrome unless it includes specific modifications like low carbohydrate intake and small, frequent meals. However, this option alone does not directly indicate dumping syndrome.
C. Skin appearance. The client is noted to be diaphoretic and pale, which are common symptoms of dumping syndrome due to the vasomotor response and hypoglycemia that can follow rapid gastric emptying.
D. Blood glucose level. The client's fasting blood glucose dropped to 65 mg/dL, which is below the normal range. Hypoglycemia is a hallmark of late dumping syndrome, resulting from excessive insulin release after rapid carbohydrate absorption in the small intestine.
E. WBC count. The WBC count is within normal range (9,000/mm³) and does not indicate dumping syndrome or an infectious process. It is not relevant in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Complete activities for one client before moving to the next client. Focusing on completing tasks for one client at a time helps ensure safe, uninterrupted care, reduces errors, and promotes efficiency in task completion.
B. Document assessment findings and interventions after providing care for a group of clients. Delaying documentation increases the risk of forgetting important details and may lead to inaccuracies. Documentation should be done promptly after care is provided.
C. Gather supplies for a client's dressing change after removing the old dressing. Supplies should be gathered before beginning a procedure to prevent delays, reduce exposure time, and avoid leaving the client unattended.
D. Delay cleaning personal work area until the end of the shift. Maintaining a clean and organized workspace throughout the shift improves efficiency, infection control, and safety, especially in shared environments.
Correct Answer is A
Explanation
A. Hydrocodone. This is an opioid analgesic appropriate for moderate to severe pain, such as a pain rating of 7/10. It is commonly used for acute pain management in cases like fractures and provides effective relief when non-opioids are insufficient.
B. Acetaminophen. While useful for mild to moderate pain, acetaminophen alone is likely inadequate for severe pain like that associated with a fracture rated 7/10.
C. Fentanyl. Fentanyl is a potent opioid used for severe or chronic pain, often in controlled settings such as surgery or cancer care. For an acute fracture, hydrocodone is typically preferred unless pain is extreme or uncontrolled.
D. Aspirin. Aspirin is primarily used for mild pain or anti-inflammatory purposes and is not appropriate as a first-line agent for severe pain. Additionally, it may increase the risk of bleeding, which is a consideration in trauma cases.
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