Bariatric patient Flashcards
Obesity is more common in which gender?
Women
What three ethnic groups are at highest risk for obesity?
- African American
- Native American
- Hispanic
What is the first preventable cause of death?
Smoking
What is the second preventable cause of death?
Obesity
What eight health problems can an obese patients experience?
- High blood pressure
- Heart disease
- Diabetes
- stroke
- Osteoarthritis
- Sleep Apnea
- Premature Death
- Decrease in quality of life
What is the equation for body mass index?
Weight/height 2 (m)
A pt with a BMI of 40 or more is considered?
morbidly obese
A pt with a BMI of 20 to 24.9 is considered?
Normal
A pt who is underweight BMI would be?
under 20
A pt who is overweight BMI would be?
25 to 29.9
What percentile is a child who has overweight BMI?
85th to 94th percentile
A child who is considered overweight BMI?
above 95th percentile
A preoperative consideration for morbidly obese is that they are at risk for?
- Stroke
2. Sudden death
What are some psychosocial concerns that are bias against obese pts?
- Lack of self control and will
- Are lazy, sloppy and dirty
- More difficult to manage
- Less intelligent
a morbidly obese pt is at high risk for what regarding airway management?
Aspiration
What should be close by when considering airway management of a morbidly obese pt?
Equipment and supplies should be immediately available for managing a difficult airway.
Many obese pt with obstructive sleep apnea
are unable to do this?
lie flat for any period of time
Why should you not use a foam positioning product on a morbidly obese pt?
Traditional foam positioning products may be ineffective due to compression resulting from pts. weight
Why is a bariatric pt at risk for delayed wound healing and infection?
Epithelialization may be delayed causing poor postoperative wound healing and increase risk of infection.
Why is a bariatric pt at risk for difficult intubation?
short thick neck
What are some respiratory issues a bariatric pt might experience?
- Increase risk for hypoxia
- Increase risk for intra-abdominal pressure on the diaphragm
- Increase risk for aspiration
What circulatory issues might a bariatric pt be at risk for?
- Increase cardiac output
- Increase pulmonary Artery pressure
- Risk for inferior vena cava compression
What degree should a bed be elevated to avoid respiratory distress for postoperative recovery with a bariatric pt?
30 degree
How should a bariatric pt be transferred from a stretcher to the OR bed?
lateral
Specialized hydraulics should be capable of lifting pts weighing?
800 to 1000 lbs
Why is two safety straps needed for a bariatric pt?
- instability
2. weight load shift
Where are the two straps placed?
- across pt thigh
2. over pt lower leg
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?
right flank
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?
- upper chest
2. pelvis
Procedure beds are designed to safely support what pt weight?
500lbs
For bariatric pts, use of a heavy duty procedure bed that lift articulates and support what weight of the pt?
800-1000lbs
What length should instruments be when operating on a bariatric pt?
Long and large
What should a RN do prior to applying an ESU dispersive pad?
Check manufacture instruction for all equipment to determine grounding site
What type of tourniquet cuff should be use on a bariatric pt?
Wide contour cuffs
To be medically considered for bariatric surgery a pt must have BMI of?
Greater than 40
or eligible greater than 35 if have serious obesity related complications such as diabetes or obstructive sleep apnea
What type of diet is a bariatric pt placed on prior to surgery?
Clear liquid diet
How many days does a bariatric pt prep dietary wise for surgery?
two to three
Which surgery places an implantable device around the upper most part of the stomach?
Adjustable Gastric Band
A vertical sleeve gastrectomy dissects how much of the stomach?
3/4 of the stomach
Surgery that bypasses a portion of the small intestine to create 15 to 30 ml stomach pouch?
roux-en y gastric bypass
Early complications that can occur with gastric bypass surgery?
- bleeding
- leaking from anastomosis staple line
- DVT/PE
- Wound infection
- Dehydration
- N/v
Late complications that can occur with gastric bypass surgery?
- Abdominal pain
- Gallbladder disease
- Internal hernia
- marginal ulcer
- Stricture or stenosis
- Band slip or erosion
- Nutritional deficiencies
What is the efficacy of gastric bypass surgery?
loss of 50-70% within two years
What is the best device for safe movement of the bariatric pt?
Mechanical Lifting Device
What position should be avoided due to abdominal contents pressing against the diaphragm?
Trendelenburg
This position causes increase blood flow from lower extremity into central and pulmonary circulation causing vascular congestion.
Which position requires placing the pts feet against a padded footboard to ensure alignment and that its flat against the board?
Reverse Trendelenburg
This prevents rotation and increased pressure on the ankles
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?
Lithotomy
This position is preferred over prone as the bulk of the pt’s panniculus can be displaced?
lateral
What medication safety should be considered when taking care of bariatric pt?
they may require larger doses of medication based on their weight which should be in pounds and kilograms to minimize medication error
Why is dvt prevention important for bariatric pts?
Bariatric pt are at higher risk
What should be considered with surgical counts during a bariatric case?
Pt who have a greater BMI are at risk for a complication of retained surgical items
