Dumping Syndrome Flashcards
Patho of dumping syndrome
Rapid emptying of stomach -> jejunum-> fluid shift from blood stream into jejunum -> decreased blood volume -> shock-like manifestations
Describe Dumping syndrome
Group of vasomotor & GI symptoms caused by rapid emptying of gastric content to jejunum
Initial s/sx
Sweating & pallor
Early s/sx occurs
5-30 min after eating
Other early s/sx: W(D)TF-DND(P)-A
Weakness & dizziness
Tachycardia
Feeling of fullness & discomfort
Diarrhea
Diaphoresis & palpitations
Nausea
Abdominal cramps
Late signs occurs
2-3 hours after eating
Late sign
Hyperglycemia(initial): insulin secretion then hypoglycemia
Position during eating/meals
Lying or recumbent
Position after eating/meals and rationale
Left-side lying ( jejunum is on the R)
Recumbent or slightly elevated
- to prevent rapid emptying by gravity for 30 mins
Diet
High protein(3-4 hours emptying)
High fats
Limit carbohydrates( no simple sugar): 1-2 hours
- small frequent meals
Fluid intake to prevent dumping syndrome
Take fluid after meals or between meals not with meals.
These should be avoided bec. They are stimulant that causes rapid emptying
Ver Hot & cold food and beverages
Give anticholinergics or antispasmodics when?
30 min before meals
Example of anticholinergic or antispasmodic meds ( BRAL-NP
Bentyl ( dicyclomine)
Robinul (glycopyrrolate)
Atropine sulfate
Levsin
Nulev (hyoscyamine)
Propantheline bromide
Ulcers that occur when gastric acids came in contact with area of anastomosis w/duodenum or jejunum
Marginal ulcers
is caused by reflux of duodenal contents
Alkaline reflux gastritis
Due to partial or total loss of intrinsic factor secreted by parietal cells
Vit B12 deficiency
What does parietal cells produces
hydrochloric acid
Intrinsic factors
Result from deficiency of intrinsic factor necessary for intestinal absorption of vit B12
Pernicious Anemia
Assessment in pernicious anemia: SSS-WPF
Smooth beefy red tongue
Severe pallor
Slight jaundice
Weight loss
Paresthesia of hands & feet
Fatigue
Tx for pernicious anemia
Vit B12 injection IM, Z-track method
- severe: weekly then monthly for 100-200microgram(mcg)
Mild/moderate: 3-4 mos or as maintenance
