Dumping Syndrome & GI Surgery

Med Surg: GI - Gastrointestinal

Pathophysiology
Occurs when the stomach empties too quickly into the duodenum (small intestines)
after eating. This DUMPING causes a massive fluid shift leading to severe pain, low
blood pressure, & nausea/ vomiting 30 minutes after eating.
Commonly seen after any type of bariatric surgery like a gastric bypass or
gastrectomy (removal of the stomach), typically done for our bariatric clients
who are morbidly obsese.

Causes GI SURGERY Post-Operative Care

Key terms Priority

Gastrectomy
Gastrojejunostomy (Billroth II surgery)
Partial Gastrectomy 1. NPO until bowel sounds return NCLEX TIP !!!

Sleeve Gastrectomy 2. Apply SCD (sequential compression devices)

3. Early ambulation
4. Incentive spirometer Q Hour
5. Teach splinting the incision when coughing

Signs & Symptoms

Priority action:
PRIORITY ACTION
Dehiscence / Evisceration NCLEX TIPS
Report to HCP / Surgeon NORMAL

1. Stay with client & call for help

HIGH
LOW

Hypotension & Tachycardia 2. Position: Low Fowler’s with knees bent 0.9%
Sodium Chloride
250 mL

Sweating, Dizziness, NCLEX TIP

3. Sterile gauze & saline to cover the wound
Severe abdominal pain, N&V HR > 100

4. Report to HCP / Surgeon

30 minutes AFTER eating

MEMORY TRICK

Education 4 NCLEX TIPS

NORMAL

1. HIGH protein, fiber, & fats foods

HIGH
LOW

Low carbohydrates
2. Small, frequent meals
3. LIE DOWN after eating (left side)
Think for Dumping syndrome-
4. No fluids with meals
we see DUMPing of Blood pressure
(30 min before / after food)
Common NCLEX Question
A client recovering from a
partial gastrectomy presents KAPLAN HESI
with vomiting, severe Following a gastrectomy … What instructions
abdominal pain, blood pressure Priority action for a client with bowel should the nurse include ... to prevent
protruding through abdomen dumping syndrome?
105/62, heart rate of 122/min,
temperature of 100.5 F. Which
1
HCP/ Surgeon ● Divide meals into 6 small feedings
● Call for help (the client needs
action should the nurse take?
emergency surgery and the nurse
should not leave the client) Which nursing action is important after a
patient has a partial gastrectomy to prevent
1. Administer a bolus of IV fluid further complications?
2. Assess blood glucose for Help!!
hypoglycemia ● Measure the patient’s serum vitamin
B12 level
3. Immediately notify the HCP
or surgeon
4. Insert nasogastric tube B12

Notes