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Pharm 2 > Exam #2 Obesity > Flashcards

Exam #2 Obesity Flashcards

1
Q

Metabolic Syndrome Definition

A

( Insulin Resistance )
Risk factor for CV and Diabetes
Females have a higher risk!
Continues to increase with low physical activity levels!

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2
Q

Metabolic Syndrome
( Needs three of these factors )

A
  1. Abdominal Obesity: 40+ Men ( Waist )
    35+ ( Women )
  2. Hyperglycemia: Fasting BG above 100 mg/dl
  3. Hypertension: 130 mm hg or more, 85 mm hg
  4. Hyperlipidemia: Triglyceride level of 150 mg/dl
    - HDL: Less than 40 men, Less than 50 for women
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3
Q

Initial Nutrition Screening

A

Should be done within 24 hours of patients hospital admission!

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4
Q

BSA

A

An estimate of a patients total body surface area. It reflects heat exchange, blood volume and vital organs.

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5
Q

Skinfold measurements

A

Triceps and subscapular skinfolds

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6
Q

BMI

A

Estimates total fat stores within the body by the relationship of weight to height

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7
Q

BMI Below 18.5

A

Underweight

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8
Q

BMI 18.5-24.9

A

Normal

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9
Q

BMI 25.0-29.9

A

Overweight

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10
Q

BMI 30.0 and above

A

Obese

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11
Q

Limitations of BMI calculation include…

A

Physically fit, athletic or muscular patients.

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12
Q

Obese Class 1

A

30-34.99

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13
Q

Obese Class 2

A

35-39.9

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14
Q

Obese Class 3

A

40 kg/m

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15
Q

Causes of Obesity

A

Consuming high fat, high cholesterol diets = Most Common Cause
- Physical Inactivity: 75 mins a week
- Drug Therapy: Meds that cause weight gain = Corticosteroids, Estrogen, NSAIDS, Antihypertensives, Antidepressants, Antiepileptics

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16
Q

Obesity Interventions Nutrition

A

Improving Nutrition: #1
Diet: Short term fasting/ low calorie diets, requires cardiac eval.
- 1200-1800 cal
- Unbalanced low energy diet: Low carb
Nutrition: Low risk high benefit

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17
Q

Obesity Interventions Cont

A

Exercise Program:
-Adding physical activity
- 20 mins of walking daily
- Increasing indurance

18
Q

Lipase Inhibitors
Orlistat

A

Inhibits gastric and pancreatic lipases and promotes weight loss by decreasing the amount of dietary fat absorbed in intestines
- S/A/E: Oily Stools! , N/V
Admin: Take with meal, MVI daily

19
Q

Amphetamine - Related Anorexigenic Agent
Phentermine

A

Appetite Suppressant
- Avoid in patients with serious heart rhythm disturbances
- Take 1 hour before breakfast
- CNS: S/A/E: Dizziness, dry mouth, difficulty sleeping, N/V, diarrhea, constipation

20
Q

GLP-1 Analogs
Semaglutide and Liraglutide

A

-Glucagon like peptide 1
Increases insulin secretion, decreases glucagon release and slows gastric emptying.
- Change injection sites

21
Q

Bariatric Surgery Eligibility

A
  • Does not respond to traditional interventions
  • BMI over 40
  • 35 or higher w other risk factors
22
Q

Gastric Bypass

A

Creating a small pouch from the stomach and connecting the newly created pouch directly to small intestine
- Food goes right to SI.
- Bypasses most of stomach.
- After Surgery: Liquids only –> Solids
- Loosing calories and nutrients + affects absorption

23
Q

Adjustable Gastric Band

A

Sillicon band around the upper part of the stomach which induces weight loss by restricting food intake.
- Lessen feelings of hunger
- Band adjusted w saline
- Digestion and absorption is normal!

24
Q

Sleeve Gastrectomy

A

Part of the stomach is separated and removed from the body
- tubelike structure
- Can’t hold as much food
- *** produces less appetite regulating hormone ghrelin

25
Q

Operative Procedures
PRE OP

A

Increased risk for DVT, PE, Death
- Weight loss prior may be required
- Psychological assessment: AMS, Cog, Support

26
Q

Operative Procedures
INTRA OP

A

Gastric restriction allows for normal digestion without the nutrional deficiences
- Banding
- Vertical Sleeve

Biliopancreatic diversion and Gastric Bypass
- Fewer cals absorbed
- Nutrient loss

27
Q

Operative Procedures
POST OP

A

Monitor ABC’s
( Airway and Ventillation )
Additional Personnel
Ensure rails are not touching body
Pain
Clear liquids –> pureed –> soft

28
Q

Marasmus

A

Body fat and protein are wasted! Serum protien is preserved
- Caloric Malnutrition

29
Q

Kwashiorkor

A

Body weight normal, Serum Protein is low!
- Lack of protien

30
Q

Starvation

A

Complete lack of nutrients

31
Q

Anorexia Nervosa

A

Self Induced state of starvation resulting from a fear of fatness, even though patient is underweight.
- Low body weight, below 85%
- BDD, Body Dysmorphic
- Preoccupation with food or rituals with food

32
Q

A. N Assessment

A

Low BP, Yellow Skin, pale, dehydrated, electro imbalances, muscle weakness, no energy, ECG changes

33
Q

A.N Intervetions

A

1st: Re feeding program
- Orally
- TPN ?

34
Q

Complications of Total Enteral Nutrition

A

Refeeding Syndrome = Life threatening complication related to fluids and electrolyte shifts during aggressive nutrition rehab.
- Abdominal Distension
- Fluid, Electro Imbalance

35
Q

Bulimia Nervosa

A

Binge eating in which the patient ingests a large amount of food in a short time.
- Followed by purging behavior, self induced vomiting, excessive use of laxatives.

36
Q

B.M Characteristics

A

BMI: 18.5-30
Late adolescent or early adulthood female

37
Q

B.M Assessment

A

Russells Signs: Calluses or scars on the back of hand
Dental erosion and cavities
Self induced vomiting
Esophageal tears/ruptures

38
Q

B.M Ultimate Goal is to…

A

Improve Nutrition
- Prevent purging
- Orally is preferred food route, through GI tract because it enhances the immune system is safer, easier, less expensive and more enjoyable.

39
Q

Binge Eating Disorder

A

Loss of control over eating
- No purging!
- HTN = Binge Eating
- Binge= Overweight

40
Q

Criteria for acute care treatment …

A

Rapid weight loss or greater than 30% of body weight in 6 months
Unsuccessful weight gain
HR < 400
ECG changes
Electo disturbances
Severe depression

Pharm 2 (10 decks)

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