Which signs and symptoms should the nurse assess for in a client developing dumping syndrome after a subtotal gastrectomy?

In the context of dumping syndrome, which is a common complication following gastric surgery such as subtotal gastrectomy, the signs and symptoms primarily involve physiological reactions that occur shortly after eating.

Weakness, diaphoresis (sweating), and diarrhea are characteristic indicators of this syndrome. Weakness occurs due to rapid shifts in fluid and electrolytes following the rapid emptying of stomach contents into the small intestine. Diaphoresis is often a response to the body's stress as it attempts to manage the sudden influx of carbohydrates and subsequent insulin release, while diarrhea results from the inability of the intestines to cope with the hyperosmolar load from poorly digested food entering the lumen quickly.

The other options list signs and symptoms that do not align with the typical presentation of dumping syndrome. For example, fever, constipation, and rectal bleeding generally suggest other gastrointestinal issues, such as infection or obstruction, rather than the acute phase reaction seen in dumping syndrome. Symptoms like abdominal pain and elevated temperature may indicate complications such as infection rather than the specific physiological response to rapid gastric emptying.

Thus, recognizing these specific symptoms as characteristic of dumping syndrome is crucial for nursing assessment and management of patients following a subtotal gastrectomy.