What would the nurse suggest to reduce the risk of dumping syndrome?

Dumping syndrome is a complication of gastric surgery where high-osmolarity chyme enters the small intestine too rapidly. This triggers a fluid shift from the vasculature into the intestinal lumen, causing vasomotor symptoms like tachycardia and diaphoresis. Management focuses on slowing gastric emptying and reducing the osmotic load delivered to the duodenum. A. Drinking 10 ounces of fluids with meals: Consuming liquids during meals accelerates the transit of food into the small intestine, worsening dumping symptoms. Patients are advised to consume fluids between meals rather than with them. This ensures that the solid bolus remains in the stomach longer. B. Remaining upright for two hours after meals: Gravity facilitates the rapid descent of food into the jejunum, which precipitates an episode. Patients are encouraged to lie down or recline for 30 minutes after eating to slow the movement of chyme. This is the opposite of GERD positioning. C. Eating a high-carbohydrate diet: Simple sugars are highly osmotic and rapidly hydrolyzed, leading to a massive insulin release and hypoglycemic symptoms. The diet should be high in protein and fat but low in refined carbohydrates. This stabilizes blood glucose and slows digestion. D. Eating six small meals daily: Dividing daily intake into multiple small portions prevents the stomach from becoming overloaded. This reduces the volumetric pressure that forces food into the duodenum too quickly. Smaller boluses are processed more efficiently by the reduced gastric capacity.