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Bariatric patient Flashcards

1
Q

Obesity is more common in which gender?

A

Women

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2
Q

What three ethnic groups are at highest risk for obesity?

A
  1. African American
  2. Native American
  3. Hispanic
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3
Q

What is the first preventable cause of death?

A

Smoking

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4
Q

What is the second preventable cause of death?

A

Obesity

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5
Q

What eight health problems can an obese patients experience?

A
  1. High blood pressure
  2. Heart disease
  3. Diabetes
  4. stroke
  5. Osteoarthritis
  6. Sleep Apnea
  7. Premature Death
  8. Decrease in quality of life
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6
Q

What is the equation for body mass index?

A

Weight/height 2 (m)

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7
Q

A pt with a BMI of 40 or more is considered?

A

morbidly obese

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8
Q

A pt with a BMI of 20 to 24.9 is considered?

A

Normal

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9
Q

A pt who is underweight BMI would be?

A

under 20

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10
Q

A pt who is overweight BMI would be?

A

25 to 29.9

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11
Q

What percentile is a child who has overweight BMI?

A

85th to 94th percentile

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12
Q

A child who is considered overweight BMI?

A

above 95th percentile

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13
Q

A preoperative consideration for morbidly obese is that they are at risk for?

A
  1. Stroke

2. Sudden death

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14
Q

What are some psychosocial concerns that are bias against obese pts?

A
  1. Lack of self control and will
  2. Are lazy, sloppy and dirty
  3. More difficult to manage
  4. Less intelligent
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15
Q

a morbidly obese pt is at high risk for what regarding airway management?

A

Aspiration

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16
Q

What should be close by when considering airway management of a morbidly obese pt?

A

Equipment and supplies should be immediately available for managing a difficult airway.

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17
Q

Many obese pt with obstructive sleep apnea

are unable to do this?

A

lie flat for any period of time

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18
Q

Why should you not use a foam positioning product on a morbidly obese pt?

A

Traditional foam positioning products may be ineffective due to compression resulting from pts. weight

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19
Q

Why is a bariatric pt at risk for delayed wound healing and infection?

A

Epithelialization may be delayed causing poor postoperative wound healing and increase risk of infection.

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20
Q

Why is a bariatric pt at risk for difficult intubation?

A

short thick neck

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21
Q

What are some respiratory issues a bariatric pt might experience?

A
  1. Increase risk for hypoxia
  2. Increase risk for intra-abdominal pressure on the diaphragm
  3. Increase risk for aspiration
22
Q

What circulatory issues might a bariatric pt be at risk for?

A
  1. Increase cardiac output
  2. Increase pulmonary Artery pressure
  3. Risk for inferior vena cava compression
23
Q

What degree should a bed be elevated to avoid respiratory distress for postoperative recovery with a bariatric pt?

A

30 degree

24
Q

How should a bariatric pt be transferred from a stretcher to the OR bed?

A

lateral

25
Q

Specialized hydraulics should be capable of lifting pts weighing?

A

800 to 1000 lbs

26
Q

Why is two safety straps needed for a bariatric pt?

A
  1. instability

2. weight load shift

27
Q

Where are the two straps placed?

A
  1. across pt thigh

2. over pt lower leg

28
Q

A bariatric pt who is in supine position would require a roll or wedge to be placed where to relieve compression of the vena cava?

A

right flank

29
Q

In a prone position, where should a bariatric pt be supported to minimize abdominal viscera and reduce pressure on the diaphragm and inferior vena cava?

A
  1. upper chest

2. pelvis

30
Q

Procedure beds are designed to safely support what pt weight?

A

500lbs

31
Q

For bariatric pts, use of a heavy duty procedure bed that lift articulates and support what weight of the pt?

A

800-1000lbs

32
Q

What length should instruments be when operating on a bariatric pt?

A

Long and large

33
Q

What should a RN do prior to applying an ESU dispersive pad?

A

Check manufacture instruction for all equipment to determine grounding site

34
Q

What type of tourniquet cuff should be use on a bariatric pt?

A

Wide contour cuffs

35
Q

To be medically considered for bariatric surgery a pt must have BMI of?

A

Greater than 40

or eligible greater than 35 if have serious obesity related complications such as diabetes or obstructive sleep apnea

36
Q

What type of diet is a bariatric pt placed on prior to surgery?

A

Clear liquid diet

37
Q

How many days does a bariatric pt prep dietary wise for surgery?

A

two to three

38
Q

Which surgery places an implantable device around the upper most part of the stomach?

A

Adjustable Gastric Band

39
Q

A vertical sleeve gastrectomy dissects how much of the stomach?

A

3/4 of the stomach

40
Q

Surgery that bypasses a portion of the small intestine to create 15 to 30 ml stomach pouch?

A

roux-en y gastric bypass

41
Q

Early complications that can occur with gastric bypass surgery?

A
  1. bleeding
  2. leaking from anastomosis staple line
  3. DVT/PE
  4. Wound infection
  5. Dehydration
  6. N/v
42
Q

Late complications that can occur with gastric bypass surgery?

A
  1. Abdominal pain
  2. Gallbladder disease
  3. Internal hernia
  4. marginal ulcer
  5. Stricture or stenosis
  6. Band slip or erosion
  7. Nutritional deficiencies
43
Q

What is the efficacy of gastric bypass surgery?

A

loss of 50-70% within two years

44
Q

What is the best device for safe movement of the bariatric pt?

A

Mechanical Lifting Device

45
Q

What position should be avoided due to abdominal contents pressing against the diaphragm?

A

Trendelenburg
This position causes increase blood flow from lower extremity into central and pulmonary circulation causing vascular congestion.

46
Q

Which position requires placing the pts feet against a padded footboard to ensure alignment and that its flat against the board?

A

Reverse Trendelenburg

This prevents rotation and increased pressure on the ankles

47
Q

Which position should be avoided with a bariatric pt due to the weight of the pt thighs pressing on his abdomen and raising intra-abdominal pressure increasing risk of circulatory complications?

A

Lithotomy

48
Q

This position is preferred over prone as the bulk of the pt’s panniculus can be displaced?

A

lateral

49
Q

What medication safety should be considered when taking care of bariatric pt?

A

they may require larger doses of medication based on their weight which should be in pounds and kilograms to minimize medication error

50
Q

Why is dvt prevention important for bariatric pts?

A

Bariatric pt are at higher risk

51
Q

What should be considered with surgical counts during a bariatric case?

A

Pt who have a greater BMI are at risk for a complication of retained surgical items

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