CBC Post-Operative Patient Management 2 — Questions and Answers
Question 1: A patient 3 weeks after Roux-en-Y gastric bypass reports dizziness, sweating, and rapid heartbeat 30 minutes after eating a sugary dessert. What is the most likely cause?
- Early dumping syndrome (Correct answer)
- Anastomotic leak
- Wound infection
- Vitamin B12 deficiency
Correct answer: Early dumping syndrome
Early dumping syndrome occurs 15-30 minutes after eating high-sugar foods due to rapid gastric emptying into the small intestine.
Question 2: How should a counselor advise a post-bariatric patient regarding fluid intake during meals?
- Avoid drinking liquids 30 minutes before and after meals (Correct answer)
- Drink at least 16 oz of water with every meal
- Only drink carbonated beverages with meals
- Fluids should always be consumed with solid food
Correct answer: Avoid drinking liquids 30 minutes before and after meals
Separating fluids from meals prevents overfilling the small pouch, reduces discomfort, and helps patients eat adequate protein.
Question 3: Which protein intake goal is generally recommended for patients in the months following bariatric surgery?
- 60-80 grams per day (Correct answer)
- 10-20 grams per day
- 150-200 grams per day
- Protein is not a priority after surgery
Correct answer: 60-80 grams per day
Most guidelines recommend at least 60-80 grams of protein daily to preserve lean muscle mass during rapid weight loss.
Question 4: A patient 6 months post-surgery has stopped attending support groups and reports feeling 'like the surgery should do all the work.' What is the counselor's best response?
- Explore ambivalence and re-engage the patient in behavioral change strategies (Correct answer)
- Agree that surgery alone determines outcomes
- Discharge the patient from counseling
- Recommend immediate revision surgery
Correct answer: Explore ambivalence and re-engage the patient in behavioral change strategies
Surgery is a tool, and long-term success depends on sustained behavioral change, which the counselor should help the patient recommit to.
Question 5: Which vitamin deficiency is most associated with neurological symptoms such as numbness and tingling after gastric bypass?
- Vitamin B12 (Correct answer)
- Vitamin C
- Vitamin K
- Biotin
Correct answer: Vitamin B12
B12 absorption requires intrinsic factor and stomach acid, both reduced after bypass, and deficiency causes neuropathy.
Question 6: When should a post-operative bariatric patient typically progress from full liquids to pureed foods?
- Around 2-3 weeks after surgery, per the surgical team's protocol (Correct answer)
- On the first day home from the hospital
- Only after 6 months
- Diet stages are unnecessary after surgery
Correct answer: Around 2-3 weeks after surgery, per the surgical team's protocol
Most programs advance patients from liquids to pureed foods at roughly 2-3 weeks, following the surgeon's staged diet protocol.
Question 7: A patient reports persistent vomiting after progressing to solid foods. What should the counselor recommend first?
- Contact the surgical team promptly to rule out stricture or other complications (Correct answer)
- Ignore it as a normal adjustment
- Increase portion sizes to push through
- Switch to carbonated drinks to settle the stomach
Correct answer: Contact the surgical team promptly to rule out stricture or other complications
Persistent vomiting may indicate a stricture or obstruction and requires timely medical evaluation.
CBC Post-Operative Patient Management 2
A patient 3 weeks after Roux-en-Y gastric bypass reports dizziness, sweating, and rapid heartbeat 30 minutes after eating a sugary dessert.
What is the most likely cause?