A patient asks the Home Health Nurse what the distressing symptoms of dumping syndrome result from? What physiologic occurrence would the nurse explain?
A) Irritation of the phrenic nerve due to diaphragmatic pressure
B) Chronic malabsorption of iron and vitamins A and C
C) Reflux of bile into the distal esophagus
D) Osmotic transport of extracellular fluid into the gastrointestinal tract
Ans: D
Feedback: Following gastric surgery, the gastric remnant is anastamosed to the jejunum. When substances high in carbohydrates and electrolytes are ingested rapidly, they pass directly into the jejunum. Extracellular fluid from the bloodstream is drawn into the jejunum to dilute these hypertonic intestinal contents. Irritation of the phrenic nerve causes hiccups. Reflux of bile is an etiologic factor associated with the development of GERD. Patients who have undergone partial gastrectomy or bariatric surgery may absorb vitamins and minerals less effectively; however, this change is unrelated to the occurrence of dumping syndrome.
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