Gastrectomy (13 Questions)

1. Mr. Émile Bouchard, a 49-year-old patient, is recovering in the postoperative unit following bariatric surgery. He is alert but slightly drowsy from anesthesia. You are
monitoring his airway, respiratory status, and surgical site. The physician has not yet prescribed ambulation, and Mr. Bouchard has not reported any pain or nausea.

Question:
How should you position the patient? *
1.2 A few days later, approximately 30 minutes after finishing his meal, he reports feeling lightheaded, flushed, and nauseated. He also complains of abdominal cramping and diarrhea. On assessment, his heart rate is 112 bpm, and he appears diaphoretic and anxious. He tells the nurse, “I feel like my heart is racing and I might faint.”

Question:
What do you suspect is happening to the patient? *
1.3 Mr. Émile Bouchard is preparing for discharge after an uncomplicated recovery from his surgery. As the nurse, you review postoperative education with him, including wound care, physical activity, and dietary guidelines. Mr. Bouchard expresses concerns about how his eating habits will need to change and asks, “What kind of diet should I follow so I don’t get sick or gain the weight back?”

Question:
Which discharge teaching related to diet is most important? *
2. Mr. Dubé, 63 years old, is recovering from gastric surgery. After lunch, he becomes pale, sweaty, and complains of feeling “light-headed and weak.” His blood pressure drops to 92/54 mmHg, and his pulse is 118 bpm.

Question:
Which intervention should the nurse implement as a priority? *
3. Mme. Tremblay, 52 years old, is four weeks postoperative from a Roux-en-Y gastric bypass. She reports that she often feels fine after eating, but 1 to 3 hours later, she experiences intense sweating, shakiness, heart palpitations, and weakness to the point where she must sit or lie down.

She keeps snacks in her purse because she fears the episodes. She says breakfast is usually “something quick,” such as cereal with sugar or a muffin. Her fasting glucose in the clinic today is normal.

Question:
What is the most likely cause of her symptoms? *
4. Mr. Fontaine, 56 years old, is recovering from distal gastrectomy for gastric cancer. He reports worsening episodes of bloating, dizziness, and rapid heartbeat within 20 minutes of meals.

He reveals that he often drinks a large glass of water during meals because food “goes down too fast” otherwise. His meals include soups, soft breads, and noodles. His blood pressure today is 104/60 mmHg after lunch, and he states he feels “washed out.”

Question:
What dietary change should the nurse recommend? *
5. Mme. Desrosiers, 39 years old, is learning how to manage dumping syndrome after undergoing sleeve gastrectomy. She says she is always hungry, so she eats three large meals plus pastries throughout the day.

Her weight loss has been rapid, but she reports abdominal cramping, sweating, and diarrhea shortly after breakfast and lunch. She also says she often eats while standing and finishes her meals in under 10 minutes.

Question:
Which instruction is most appropriate? *
6. Mr. Henderson, 67 years old, had gastric resection for ulcer disease. During lunch he consumed white bread, mashed potatoes, and fruit juice. Twenty minutes later, he experiences flushing, dizziness, abdominal cramping, and mild hypotension.

He says this happens most often after “soft, easy-to-digest foods,” especially carbohydrates. He denies fever or nausea between episodes and maintains good hydration.

Question:
Which dietary change would best reduce his symptoms? *
7. Mme. Pelletier, 44 years old, had Billroth II gastric surgery four weeks ago. She states she often feels bloated, shaky, and weak after eating a bowl of cereal with milk in the morning. She says, “I thought milk was healthy, but I feel terrible after I have it.”
She also reports sweating, palpitations, and a need to lie down immediately after breakfast. She has lost more weight than expected and now avoids some foods because she fears the reactions.

Question:
Which explanation should the nurse give? *
8. Mr. Gervais, 59 years old, is on postoperative day 21 following partial gastrectomy. He reports feeling extremely hungry, so he tends to eat meals quickly. After lunch today (soup, bread, and juice), he suddenly became light-headed, had palpitations, and needed to sit down.

He says these episodes happen more often when he eats in a hurry or when he eats soft foods that “slide down easily.” His vitals normalize after resting for 15 minutes.

Question:
What instruction is most important? *
9. Mme. Arsenault, 70 years old, is on postoperative day 14 after gastrectomy for gastric cancer. She reports that she feels faint, sweaty, and shaky after certain meals, mainly breakfast. She keeps a food journal and notes that symptoms occur after toast with jam and juice.

When she eats eggs, chicken, vegetables, or oatmeal with nuts, she feels fine. She is worried that something is “wrong with her surgery,” but her incision and vital signs are normal.

Question:
Which meal is most likely causing dumping syndrome? *
10. Mr. Lefebvre, 72 years old, had gastric surgery six weeks ago. He reports that 2 hours after meals, he becomes shaky, sweaty, and confused. He tested his glucose at home during an episode and found it was 3.1 mmol/L.

He eats mainly toast, rice, bananas, and applesauce because they are easy to digest. He does not include protein or fats regularly in meals because he fears they will upset his stomach.

Question:
Which dietary strategy is most effective? *