Chapter 45: Obesity Flashcards
ten cancers most strongly linked to excess body fat
breast, colorectal, endometrial, esophagus, gallbladder, kidney, liver, ovarian, stomach, thyroid
type of restrictive surgery for obesity in which the size of the stomach is reduced by folding the stomach wall inward and then placing sutures to secure the folded stomach wall
gastric plication
combination of restrictive and malabsorptive surgery for obesity that involves creating a small gastric pouch and attaching it directly to the small intestine using a Y-shaped limb of the small bowel
roux-en-Y gastric bypass (RYGB)
postoperative bariatric surgery: at first, patient is _______ and tested to ensure no leak from ______________
NPO, anastomosis
most Jackson-Pratt drains will be discontinued when drainage is <___ cc per day
30
android (apple) or gynoid (pear) shape: health risks: subcutaneous fat traps and stores fat
gynoid (pear)
postoperative bariatric surgery: when first starting back on diet, start with ____ mL of clear liquids with _____ sugar every _______ minutes, then gradually increase intake to goal of _____ mL every _____ minutes, then progress to __________ full liquid
15, low, 10-15, 90, 30, low-calorie
with adjustable gastric banding, ________ is common, so patient should learn about what to eat, eat _______, and add extra _________ to diet
reflux, slowly, vitamins
healthy weight loss is _____ lbs per week
1-2
as people age, basal metabolic rate (increases, decreases)
decreases
android (apple) or gynoid (pear) shape: health risks: hypertension
android (apple)
overeating develops (early, late) in life and alters ________
early, satiety
android (apple) or gynoid (pear) shape: fat mainly in upper legs
gynoid (pear)
cause of primary obesity
intaking more calories than energy expenditure
android (apple) or gynoid (pear) shape: health risks: decreased HDL cholesterol
android (apple)
android (apple) or gynoid (pear) shape: health risks: heart disease
android (apple)
preoperative care before bariatric surgery includes identifying any ______________, having correct ______ and __________________ size, accommodations for _________, ______________ considerations, assessment of _________ and _______ sounds, ____ size, and teaching about ______________ exercises to be used postoperatively
comorbidities, gown, blood pressure cuff, weight, wheelchair, heart, lung, IV, respiratory
it takes ___________ to establish a habit
6 weeks
when caring for a patient with gastric sleeve, patient will have ______________ drain, will need to be NPO for __________, and a(n) ________________ (procedure) will be done the next day to ensure no leakage
Jackson-Pratt, 24 hours, swallow X-ray
three cardiovascular health risks of obesity
stroke, hypertension, sleep apnea
android (apple) or gynoid (pear) shape: health risks: visceral fat more acute, causing decreased insulin sensitivity
android (apple)
five criteria for metabolic syndrome (must meet ____ criteria to diagnose)
three
1. waist circumference: ≥40 in (102 cm) men; ≥35 in (89 cm) women
2. triglycerides: >150 mg/dL OR drug treatment for high triglycerides
3. HDL cholesterol <40 mg/dL men, <50 mg/dL women OR drug treatment for high cholesterol
4. BP ≥130 mm Hg systolic OR ≥85 mmHg diastolic OR drug treatment for hypertension
5. fasting glucose ≥100 mg/dL OR drug treatment for elevated glucose
android (apple) or gynoid (pear) shape: fat also found over upper body (neck, arms, shoulders)
android (apple)
to lose weight, need ______ minutes of moderate exercise or _____ minutes of vigorous exercise per week
150, 75
this disease can cause liver problems from fat deposits that can turn into cirrhosis
NASH (nonalcoholic steatohepatitis)
android (apple) or gynoid (pear) shape: health risks: varicose veins
gynoid (pear)
four environmental factors that contribute to obesity
- access to high-calorie energy dense food
- increased portion size
- decreased exercise
- socioeconomic status
increased weight puts stress on knees and hips, causing ______________
osteoarthritis
postoperative care for bariatric surgery include assessment of _____________, _____________, and _________; _______ precautions; walking _____ times each day the evening of surgery; and ______ and _______ management
airway, skin, wound; DVT; 3-4; pain, diet
android (apple) or gynoid (pear) shape: greater risk for obesity-related complications
android (apple)
postoperative bariatric surgery: patients will progress to typical diet in ________ weeks with possible _________ supplements (time frame is same for when most will typically lose weight)
4-6, protein
android (apple) or gynoid (pear) shape: health risks: osteoporosis
gynoid (pear)
android (apple) or gynoid (pear) shape: health risks: cellulite
gynoid (pear)
three psychosocial factors that contribute to obesity
- associations begin in childhood
- social component
- stress, sadness, anxiety
BMI extreme obese range
> 40
android (apple) or gynoid (pear) shape: fat mainly in abdominal area
android (apple)
type of restrictive surgery for obesity in which 75% of stomach is removed and this shape stomach is created with 60-150 mL capacity
sleeve gastrectomy or gastric sleeve
postoperative pain from bariatric surgery could be from a(n) ___________________ rather than ___________ pain
anastomosis leak, surgical
android (apple) or gynoid (pear) shape: health risks: increased triglycerides
android (apple)
android (apple) or gynoid (pear) shape: health risks: breast and endometrial cancer
android (apple)
android (apple) or gynoid (pear) shape: health risks: diabetes
android (apple)
empty a Jackson-Pratt drain when it is _____ full; ______ times a day
1/2; 1-2
milking the Jackson-Pratt drain prevents _______________ in the tube; do this every __________
clotting, 4 hours
android (apple) or gynoid (pear) shape: health risks: trapped fatty acids stored as triglycerides
gynoid (pear)
type of restrictive surgery for obesity in which an inflated balloon is inserted to occupy space in the stomach
intragastric balloon
once weight loss is achieved, _________ minutes of exercise per week is recommended to maintain weight loss or prevent weight gain
200-300
android obesity has (low, high) LDL, (low, high) HDL, and (low, high) triglycerides
high, low, high
eight health risks associated with obesity
cardiovascular, musculoskeletal, cancers, respiratory, diabetes, depression, low self-esteem, social stigma
after emptying a Jackson-Pratt drain, put ____________ on the plug and _____________ the bulb before recapping
alcohol, compress
appropriate nutrition therapy for obesity includes these six things
fruits
vegetables
whole grains
fat-free or low-fat dairy
lean meat, fish, poultry, eggs
appropriate food intake
BMI healthy weight range
18-24.9
BMI obese range (early)
30-39.9
android (apple) or gynoid (pear) shape: has a better prognosis but hard to treat
gynoid (pear)
after a roux-en-Y gastric bypass (RYGB) surgery, these three things are concerns
pernicious anemia (need B12 injections)
malnutrition (from poor absorption)
dumping syndrome
sleep apnea causes more _______________ work and stresses the _________
respiratory, heart
three GI/liver health risks of obesity
GERD, gallstones, NASH
type of restrictive surgery for obesity in which an inflatable band encircles the stomach with creation of a gastric pouch of 30 mL that later stretches to 60-90 mL
adjustable gastric banding
cause of secondary obesity
health problem (such as Cushing’s, hypothyroidism, polycystic ovary syndrome)
BMI overweight range
25-29.9
type of malabsorptive surgery for obesity in which the size of the stomach is reduced, and part of the small intestine is diverted from the GI tract allowing a pathway for bile and pancreatic enzymes
biliopancreatic diversion with or without duodenal switch
BMI underweight range
<18