In which of the condition patient is indicated to take milk initially with small amount of easily digested di… - RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Edition 3

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Explanation

In the traditional management of peptic ulcers, a bland diet including milk was recommended.
The rationale was that milk provides a temporary buffering effect, neutralizing gastric acid and coating the stomach lining to reduce pain and irritation.
This approach involved small, frequent meals with easily digestible foods to promote healing of the ulcerated mucosa.
While modern guidelines have changed, this classic dietary therapy is a common topic in nursing examinations.

Option A: For acute gastritis, the initial management is typically to rest the stomach by keeping the patient NPO (nothing by mouth), followed by clear liquids. Milk is not a clear liquid and can irritate the inflamed gastric mucosa.
Option B: Indigestion (dyspepsia) is managed by identifying and avoiding individual trigger foods, which are often spicy, fatty, or acidic. There is no standard protocol to initiate a diet with milk.
Option D: Patients with malabsorption syndromes often develop secondary lactose intolerance. In this case, milk is contraindicated as it would worsen symptoms like diarrhea, gas, and bloating.

Clinical Relevance

Nursing practice connection: Use the key finding related to Traditional dietary management for peptic ulcer disease to guide bedside assessment, documentation, and the next nursing action.
Nurses play a key role in educating patients about dietary management for GI disorders. It's vital to explain the rationale behind current, evidence-based guidelines versus older, traditional advice.
Patient assessment should include tolerance to specific foods. While milk was traditionally recommended for ulcers, nurses must be aware of the potential for acid rebound and lactose intolerance.
What if? If a patient with a peptic ulcer reports increased bloating and pain an hour after drinking milk, the nurse should suspect acid rebound or lactose intolerance. The appropriate action is to document the reaction and suggest discussing it with the physician or a dietitian to modify the dietary plan.

How to Approach the Question

First, analyze the question's core components: 'milk initially' and 'easily digested diet'. This points to a specific dietary therapy for a GI condition.
Next, consider the pathophysiology of each option. Peptic ulcer involves mucosal erosion due to acid. Gastritis is inflammation. Malabsorption is impaired nutrient uptake. Indigestion is a symptom complex.
Evaluate the traditional role of milk in these conditions. Milk's ability to temporarily neutralize acid makes it a classic (though now debated) intervention for peptic ulcer pain.
Eliminate the other options based on their standard management. Gastritis requires gut rest (NPO). Malabsorption often involves lactose intolerance, making milk a poor choice. Indigestion management is about avoiding triggers, not starting with milk.
Conclude that 'Peptic ulcer' is the condition for which a milk-based, bland diet was the traditional initial therapy, which is often what is tested in exams.

Concept Tested & Keywords

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E6 Nutrition Kumud Khanna 2e pp. 244-246, 245-247