Dumping Syndrome NCLEX Practice Question

This is an NCLEX practice question about dumping syndrome. This question provides a scenario about a patient experiencing dumping syndrome, and requires the nurse to know what steps can be incorporated in the patient’s plan of care to decrease the patient’s signs and symptoms.

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Dumping Syndrome NCLEX Practice Question

A patient is post-op from a gastric resection for treatment of peptic ulcer disease. One hour after eating meals, the patient exhibits diaphoresis, tachycardia, and hypotension. In addition, the patient reports feeling abdominal cramps, weakness, and nausea. Which options below can be incorporated in the patient’s plan of care to help alleviate the patient’s signs and symptoms? Select all that apply:

A. Wait 30 minutes after meals to consume liquids.

B. Sit up for 30 minutes after eating.

C. Consume high amounts of dairy products daily.

D. Eat 5-6 small meals a day rather than 3 large meals.

E. When symptoms present, eat cold or hot food to help decrease symptoms.

Based on the scenario what is going on with this patient? Dumping Syndrome

What is dumping syndrome? It is a condition where food from the stomach enters too rapidly into the small intestine. Let the name of this condition help you: The food is DUMPED too fast into the small intestine.

How do we know that? Our scenario provides some important clues that lead us to know it is dumping syndrome. The first clue is the patient’s health history of a gastric resection.

What is a gastric resection? In a nutshell, it is the removal of the diseased portion of the stomach…hence the peptic ulcer lesion for this particular patient. Therefore, the patient will be “missing” some parts of their stomach. This is significant because the patient will lose the ability to properly churn, and instead of the churned food slowly entering into the small intestine it will be “DUMPED” rapidly, which will causes major signs and symptoms.

The second cue that leads us to determine it is dumping syndrome are the patient’s signs and symptoms. Depending on if the patient is experiencing “early” dumping (happens 15-30 minutes after a meal) or “late” dumping (happens 1-3 hours after a meal), the patient can experience diaphoresis, tachycardia, hypotension, cramping, nausea etc. Note: patients can experience both early and late dumping syndrome.

How is dumping syndrome causing the patient’s signs and symptoms? The food that rapidly enters into the small intestine is rich in sugars, which will act as a hypertonic solution. The hypertonic contents will cause fluid to rapidly move into the small intestine….leading to swelling of the small intestine “bloating”, cramping, diarrhea, hypotension, tachycardia etc. In addition, the rich amount of sugars causes the pancreas to release insulin and this leads to hypoglycemia….leading to more tachycardia, diaphoresis, nausea, weakness.

As the nurse, you can educate the patient on some ways to help decrease the signs and symptoms of dumping syndrome and this will be the answers to our question.

A. Wait 30 minutes after meals to consume liquids. TRUE! It is best to limit the amount of content being dumped into the small intestine. Therefore, the patient should avoid drinking fluids with meals but rather consume liquids 30 minutes AFTER meals.

B. Sit up for 30 minutes after eating. FALSE! The goal of decreasing the signs and symptoms of dumping syndrome is to help decrease gastric motility. The patient should LIE DOWN for 30 minutes to help decrease the rapid dumping of the contents into the small intestine.

C. Consume high amounts of dairy products daily. FALSE! Dairy products are known to cause GI distress and should be consumed in very same amounts until tolerated. The patient should instead consume high amount of proteins and complex carbs. These foods will help stabilize blood glucose levels and are broken down over longer periods of time.

D. Eat 5-6 small meals a day rather than 3 large meals. TRUE! Remember the goal is to decrease the amount of food that is rapidly entering the stomach/small intestine. It is best for the patient to consume small amounts of food throughout the day rather than 3 large meals.

E. When symptoms present, eat cold or hot food to help decrease symptoms. FALSE! Foods that are very cold or hot increase gastric motility and should be avoided. The patient should consume foods that are room temperature or warm.

Answers are A and D.

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