Nutritional Counseling Strategies Flashcards
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Read the first 7 Nutritional Counseling Strategies flashcards as text
Which micronutrient deficiency is most closely associated with rapid weight loss and persistent vomiting after bariatric surgery, requiring urgent counseling and supplementation?
Answer: Thiamine (vitamin B1)
Thiamine stores deplete within weeks, and deficiency during vomiting can cause Wernicke encephalopathy, making it a supplementation emergency.
A patient 1 year after Roux-en-Y gastric bypass asks why she must take vitamin B12 even though she eats meat. The best explanation is that:
Answer: Bypassing the stomach reduces intrinsic factor and acid needed for B12 absorption
Gastric bypass diminishes acid and intrinsic factor production, impairing B12 release and absorption regardless of dietary intake.
During a counseling session, a patient reports grazing on crackers and chips throughout the day 18 months post-op with weight regain. The most effective strategy is to:
Answer: Establish structured meal and snack times with protein-first planning
Grazing responds best to structured eating schedules that restore planned, protein-forward meals rather than bans or drastic measures.
Which counseling recommendation addresses calcium supplementation after malabsorptive bariatric procedures?
Answer: Use calcium citrate in divided doses of 500-600 mg, separated from iron
Calcium citrate absorbs without stomach acid and should be split into doses of 500-600 mg taken apart from iron to avoid competition.
A patient asks whether she can drink alcohol socially after gastric bypass. The counselor should explain that:
Answer: Altered anatomy speeds absorption, raising intoxication and addiction transfer risk
Post-bypass patients absorb alcohol faster and peak higher, increasing both intoxication risk and susceptibility to alcohol use disorder.
In the transtheoretical (stages of change) model, a preoperative patient who is gathering information about post-surgery diets but has not changed eating habits is most likely in which stage?
Answer: Contemplation or preparation
Actively considering and preparing for change without yet acting places the patient between contemplation and preparation.
Which fluid counseling target is standard for post-bariatric patients to prevent dehydration?
Answer: At least 48-64 ounces of low-calorie, non-carbonated fluid daily, sipped between meals
Patients should sip at least 48-64 oz of non-carbonated, low-calorie fluids daily between meals since large gulps and carbonation are poorly tolerated.