The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the primary health care provider?

Choice A Reason: This is correct because eating frequent small meals can help the client with IBS to avoid overloading the digestive system and triggering diarrhea. The nurse should advise the client to eat slowly and chew well, and avoid foods that are spicy, fatty, or gas-producing.

Choice B Reason: This is incorrect because increasing the intake of leafy greens and other sources of dietary fiber can worsen diarrhea by increasing stool bulk and motility. The nurse should advise the client to limit or avoid high-fiber foods, such as whole grains, fruits, vegetables, nuts, and seeds, during acute flare-ups of IBS. The client can gradually reintroduce fiber when the symptoms subside.

Choice C Reason: This is correct because increasing fluids can help the client with IBS to prevent dehydration and electrolyte imbalance caused by diarrhea. The nurse should advise the client to drink at least 8 glasses of water per day and avoid caffeinated, alcoholic, or carbonated beverages that can irritate the bowel or cause gas.

Choice D Reason: This is correct because taking prescribed medications on schedule can help the client with IBS to regulate bowel patterns and reduce diarrhea. The nurse should instruct the client on how to use medications, such as antidiarrheals, antispasmodics, or probiotics, as ordered by the provider. The nurse should also monitor the client for any adverse effects or interactions of the medications.

Choice A Reason: Sweating and pallor are early signs and symptoms of dumping syndrome, which is a condition where food moves too quickly from the stomach to the small intestine, causing rapid fluid shifts and hormonal changes. Sweating and pallor are caused by hypoglycemia, which occurs when the high concentration of food in the small intestine stimulates insulin secretion.

Choice B Reason: Abdominal cramping and pain are late signs and symptoms of dumping syndrome, which occur about one to three hours after eating. Abdominal cramping and pain are caused by intestinal distension, spasms, and gas formation.

Choice C Reason: Double vision and chest pain are not signs and symptoms of dumping syndrome, but may indicate other serious conditions, such as stroke or heart attack. Double vision and chest pain should be reported to the provider immediately.

Choice D Reason: Bradycardia and indigestion are not signs and symptoms of dumping syndrome, but may be related to other gastrointestinal disorders, such as gastritis or peptic ulcer disease. Bradycardia and indigestion should be evaluated by the provider for further diagnosis and treatment.