A patient who is scheduled for gastric bypass surgery asks for information about dumping syndrome. How does the nurse explain dumping syndrome?

A. Restrict fluid intake: This is incorrect. Clients with Addison’s disease are at risk for dehydration, especially during an Addisonian crisis. Fluids should be encouraged to help maintain blood pressure and fluid balance, rather than restricting fluid intake.
B. Administer oral corticosteroids: This is the correct action. Clients with Addison's disease have insufficient cortisol production, especially during times of stress or illness. Oral corticosteroids, such as hydrocortisone, are given to replace the deficient hormones and prevent or manage an Addisonian crisis.
C. Provide a low-carbohydrate diet: This is incorrect. Clients with Addison’s disease should have a balanced diet that includes adequate carbohydrates to support energy needs, especially during stress or illness. A low-carbohydrate diet could lead to further complications like hypoglycemia.
D. Weigh the client daily: While daily weight measurements can be helpful in monitoring for fluid retention or loss, it is not a primary intervention for preventing or managing Addisonian crisis. The most critical action is providing the necessary corticosteroid replacement therapy.

A. Obtain a prescription for supplemental oxygen: This is the correct answer. The patient is experiencing hypoxia, and ensuring adequate oxygenation is the priority. Oxygen supplementation is essential to correct the hypoxia, which can exacerbate metabolic disturbances like diabetic ketoacidosis (DKA). Improving oxygenation will also support other treatments, such as insulin administration, by improving tissue perfusion.
B. Obtain a prescription to administer insulin: While insulin is a key treatment for DKA, addressing hypoxia first is more urgent. Hypoxia can impair the effectiveness of insulin and other therapies, so stabilizing the patient’s oxygen levels should be prioritized before insulin administration.
C. Obtain a prescription to administer intravenous fluids: Administering fluids is important in DKA management, especially for rehydration and correcting electrolyte imbalances. However, addressing hypoxia first is the priority to stabilize the patient and ensure optimal perfusion for further interventions like fluid resuscitation.
D. Obtain a prescription to check the client's glucose level: This is not necessary, as the glucose level is likely already elevated, which is characteristic of DKA. The focus should be on stabilizing the patient's airway and oxygenation before monitoring glucose levels or starting insulin.