CBN CBN Postoperative Care & Complications 1 — Questions and Answers
Question 1: Which complication is MOST common in the immediate postoperative period following Roux-en-Y gastric bypass?
- Anastomotic leak (Correct answer)
- Deep vein thrombosis
- Marginal ulcer
- Dumping syndrome
Correct answer: Anastomotic leak
Anastomotic leak is the most feared and common serious early postoperative complication of Roux-en-Y gastric bypass, typically presenting within 72 hours.
Question 2: A post-bariatric patient presents with tachycardia (HR 120), fever, and abdominal pain on postoperative day 2. The nurse's PRIORITY action is:
- Notify the surgeon immediately and prepare for emergent evaluation (Correct answer)
- Administer IV fluids and monitor closely
- Obtain a urine culture
- Reassure the patient these are expected postoperative findings
Correct answer: Notify the surgeon immediately and prepare for emergent evaluation
Tachycardia, fever, and abdominal pain on postoperative day 2 are classic signs of anastomotic leak, a surgical emergency requiring immediate surgeon notification.
Question 3: Dumping syndrome after gastric bypass is BEST managed by:
- Eating small, frequent meals low in simple carbohydrates and avoiding liquids with meals (Correct answer)
- Increasing total daily caloric intake
- Eating larger, less frequent meals
- Consuming high-sugar beverages to restore energy quickly
Correct answer: Eating small, frequent meals low in simple carbohydrates and avoiding liquids with meals
Small frequent meals low in simple sugars and separating liquids from solids minimizes rapid gastric emptying and prevents dumping syndrome symptoms.
Question 4: Which vitamin deficiency is MOST critical to monitor after sleeve gastrectomy due to reduced acid secretion?
- Vitamin B12 (Correct answer)
- Vitamin C
- Vitamin E
- Vitamin K
Correct answer: Vitamin B12
Vitamin B12 deficiency occurs after sleeve gastrectomy because reduced gastric acid and intrinsic factor production impair B12 absorption.
Question 5: A bariatric nurse is monitoring a patient for stomal stenosis after gastric bypass. Which symptom is most indicative?
- Progressive dysphagia and intolerance of solid foods progressing to liquids (Correct answer)
- Diarrhea after every meal
- Severe right lower quadrant pain
- Sudden onset chest pain
Correct answer: Progressive dysphagia and intolerance of solid foods progressing to liquids
Stomal stenosis (stricture at the gastrojejunal anastomosis) presents as progressive dysphagia and vomiting that begins with solids and advances to liquids.
Question 6: Iron deficiency anemia after bariatric surgery is PRIMARILY caused by:
- Reduced gastric acid reducing conversion of Fe3+ to absorbable Fe2+, combined with bypassing the duodenum (Correct answer)
- Increased red blood cell destruction
- Reduced dietary iron intake alone
- Vitamin C deficiency blocking iron absorption
Correct answer: Reduced gastric acid reducing conversion of Fe3+ to absorbable Fe2+, combined with bypassing the duodenum
Bariatric surgery causes iron deficiency through reduced acid-mediated iron conversion and bypass of the duodenum, the primary site of iron absorption.
CBN CBN Postoperative Care & Complications 1
Which complication is MOST common in the immediate postoperative period following Roux-en-Y gastric bypass?