CBC Post-Surgical Nutritional Care 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 sweetened yogurt. What is the most likely cause?
- Early dumping syndrome (Correct answer)
- Anastomotic leak
- Vitamin B12 deficiency
- Gallbladder disease
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: What is the recommended daily protein intake for most patients following bariatric surgery?
- 60-80 grams (Correct answer)
- 20-30 grams
- 150-200 grams
- 40-50 grams
Correct answer: 60-80 grams
Most post-bariatric guidelines recommend 60-80 grams of protein daily to preserve lean body mass during rapid weight loss.
Question 3: Why are patients advised to avoid drinking liquids within 30 minutes of meals after bariatric surgery?
- Liquids can flush food through the pouch, reducing satiety and increasing intake (Correct answer)
- Liquids dilute stomach acid and prevent all digestion
- Drinking with meals causes vitamin toxicity
- Liquids cause the surgical staples to dissolve
Correct answer: Liquids can flush food through the pouch, reducing satiety and increasing intake
Drinking with meals accelerates pouch emptying, which reduces fullness and can lead to overeating or dumping symptoms.
Question 4: Which form of calcium is preferred for supplementation after gastric bypass, and why?
- Calcium citrate, because it does not require stomach acid for absorption (Correct answer)
- Calcium carbonate, because it is cheaper
- Calcium oxalate, because it binds fat
- Calcium chloride, because it dissolves fastest
Correct answer: Calcium citrate, because it does not require stomach acid for absorption
Calcium citrate is absorbed without gastric acid, which is reduced after bypass procedures.
Question 5: A sleeve gastrectomy patient at 6 months reports hair loss. Which nutritional factors should the counselor evaluate first?
- Protein, zinc, and iron intake (Correct answer)
- Sodium and potassium intake
- Fiber and water intake
- Carbohydrate and saturated fat intake
Correct answer: Protein, zinc, and iron intake
Telogen effluvium after bariatric surgery is commonly linked to inadequate protein, zinc, and iron.
Question 6: During the immediate post-operative diet progression, which stage typically comes directly after clear liquids?
- Full liquids (Correct answer)
- Soft foods
- Pureed foods
- Regular solid foods
Correct answer: Full liquids
The standard progression is clear liquids, then full liquids, then pureed, then soft, then regular textures.
Question 7: Why is vitamin B12 supplementation lifelong for gastric bypass patients?
- Reduced intrinsic factor and stomach acid impair B12 absorption permanently (Correct answer)
- B12 is destroyed by anesthesia during surgery
- The liver stops storing B12 after surgery
- B12 is only found in foods banned after surgery
Correct answer: Reduced intrinsic factor and stomach acid impair B12 absorption permanently
Bypassing the stomach reduces intrinsic factor and acid needed to release and absorb B12 from food.
CBC Post-Surgical Nutritional Care 2
A patient 3 weeks after Roux-en-Y gastric bypass reports dizziness, sweating, and rapid heartbeat 30 minutes after eating a sweetened yogurt.
What is the most likely cause?