Brya Bradley 3/20/13

 Gastric bypass is a surgical procedure that decreases the size of the gastric pouch. This procedure is performed on obese patients who have a very hard time losing weight. The greatest weight lose is usually achieved during the first year after surgery. However weight tends to stabilize after 18 months. Complications of this procedure include dumping syndrome in which gastric contents empty too rapidly into the small intestine overwhelming its ability to digest nutrients.

 Stabling the stomach without transaction to create a small, 30-45ml gastric pouch.  Creating an upper and lower gastric pouch and totally disconnecting the pouches.  Creating an upper gastric pouch and completely removing the lower pouch.

 With in the first 24 hours patient will be placed on IV solutions containing 5% to 10% dextrose, electrolytes, vitamins and medications needed  Clear liquids first 2-3 meals.  Pureed food after tolerance of clear liquids  Regular food 2-3 weeks after surgery. Food has to be (no fried or sweet foods)

Bread, Cereal, Pasta, and Rice 1-2 serving/d 1= ¼ cup Hot cereal (make with milk) – unsweetened oatmeal, cream of wheat, and grits. Fruit 1-2 serving/d 1 = ¼ cup Unsweetened applesauce, pureed canned / jarred peaches and pears in their own juice (not syrup), any fruit pureed without the skin, mashed ripe banana. Vegetable 1-2 serving/d 1 = ¼ cup Any vegetable (except corn) cooked soft and blended or mashed with the back of a fork. Make sure broccoli and cauliflower are cooked very well. Meat, Poultry, Fish, Nuts, Beans and Eggs 2-3 serving/d 1 = ¼ cup Chopped up soft poached eggs or scrambled eggs (egg whites might be “too light”). Blenderized meat and poultry and flaked fish cooked very soft and moist, blenderized tuna salad without vegetables. Very soft/moist meatloaf (after one week), gefilte fish, and silken tofu. Food GroupsFood Choices

Breakfast ¼-1/2 cup cooked cereal ¼- ½ cup skim plus or fat free Lactaid milk Lunch ¼ - ½ cup sugar free yogurt ¼ cup pureed fruit Dinner 1-2 oz flaked fish ¼ cup puree vegetable

 Dirksen Heitkemper, L. (2004). Medical surgical nursing. (6th ed., pp ). St Louis Missouri: Mosby Inc.  Goldenberg, L. MPH, RD, CDN., Kinsella T. MS, RD., Sherry J. MS, RD, CDN (2011). The cornell weight loss surgery program:. Dietary Guidelines for Roux-en-Y Gastric Bypass,  Ignatavicius Workman. (2013). Medical Surgical Nursing Patient-Centered Collaborative care. (7 th ed., pp ). St. Louis Missouri: Elsevier Inc.  Roth, R. (2011). Nutrition & diet therapy. (10th ed., pp ). Clifton Park, NY: Delmar Cengage Learning.