Question

A client with an ulcer had a Billroth II procedure performed 2 days ago. Which intervention would the nurse employ to prevent dumping syndrome? A. Elevate the head of the bed \(45^{\circ}\) after meals B. Encourage at least \(500 \mathrm{~mL}\) of fluids with meals C. Provide a low-carbohydrate, high-protein, and high-fat diet D. Serve high-volume meal contents

Short answer

Answer: Provide a low-carbohydrate, high-protein, and high-fat diet.

Step-by-step solution

Understand the Billroth II procedure and dumping syndrome

A Billroth II procedure is a surgical procedure used to remove part of the stomach and connect the remaining part to the jejunum (small intestine). This procedure is commonly performed on people with ulcers or gastric cancers. Dumping syndrome is a potential complication of this procedure, characterized by rapid gastric emptying, resulting in symptoms such as nausea, vomiting, abdominal cramps, and diarrhea.

Evaluate Option A: Elevate the head of the bed \(45^{\circ}\) after meals

Elevating the head of the bed after meals facilitates gastric emptying and reduces the risk of reflux and aspiration. However, this intervention does not directly prevent dumping syndrome.

Evaluate Option B: Encourage at least \(500 \mathrm{~mL}\) of fluids with meals

Encouraging intake of at least \(500 \mathrm{~mL}\) of fluids with meals will actually promote quicker gastric emptying and increase the risk of dumping syndrome. Therefore, this is not an appropriate intervention.

Evaluate Option C: Provide a low-carbohydrate, high-protein, and high-fat diet

A low-carbohydrate, high-protein, and high-fat diet slows gastric emptying and reduces the risk of dumping syndrome. This type of diet prevents rapid changes in blood sugar and allows for better absorption of nutrients. This intervention is appropriate to prevent dumping syndrome.

Evaluate Option D: Serve high-volume meal contents

Serving high-volume meal contents will increase the amount of food in the stomach, causing rapid gastric emptying, which increases the risk of dumping syndrome. This intervention is not appropriate.

Determine the most appropriate intervention to prevent dumping syndrome

The most appropriate intervention to prevent dumping syndrome in this scenario is to provide a low-carbohydrate, high-protein, and high-fat diet, which is Option C.