Mr. C is recovering from bowel surgery due to malignancy. He has < 100 cm of short intestine remaining, and the terminal ileum has been resected
The nurse identified his risk for malnutrition based on her knowledge that short bowel syndrome can lead to: 1. Delayed gastric emptying. 2. Malabsorption. 3. Fluid abnormalities. 4. Gallstones.
2
Rationale: Short bowel syndrome results in malabsorption of nutrients, vitamins, and bile salts in the small intestine and is not affected by gastric emptying which precedes the delivery of gastric contents to the intestines. Without a terminal ileum, fats, fat soluble vitamins, and bile salt are delivered directly to the colon where they are poorly absorbed. Colon resection can result in problems with absorption of fluid and electrolytes. Gall and kidney stones are the result of poor absorption of bile salts in the absence of a terminal ileum but do not directly cause malnutrition.
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