Obese Population Slides Flashcards
What defines morbid obesity?
Morbid obesity refers to a body weight 100 pounds greater than ideal body weight, with increased susceptibility to morbidity and mortality due to the physical challenges of carrying extra weight.
What are common cardiovascular complications in morbid obesity?
Myocardial hypertrophy (leading to CHF) and coronary artery disease (CAD).
How does morbid obesity affect the kidneys?
It causes hypertension and vascular changes, affecting protein waste elimination and fluid/electrolyte balance.
What complications can occur in the lower extremities due to morbid obesity?
Varicose veins, edema, thromboembolism, and thrombophlebitis due to poor venous return.
What pulmonary complications are associated with morbid obesity?
Hypoxemia, sleep apnea, decreased lung expansion, and increased risk of postoperative pulmonary infections and embolism.
How does morbid obesity impact liver and gallbladder function?
It increases the risk of liver and gallbladder disease.
What musculoskeletal and metabolic conditions are linked to morbid obesity?
Osteoarthritis and diabetes mellitus.
What hormonal and vascular abnormalities are common in morbid obesity?
Pituitary abnormalities and arteriosclerosis.
What reproductive issue can morbid obesity cause?
Dysfunctional uterine bleeding.
What should be done when lifting and transporting an obese patient?
Use mechanical lifting devices, ensure extra personnel are available, and avoid injury to hospital staff and the patient.
Why might a mechanical lifting device be necessary when transferring an obese patient to the OR?
If the patient cannot move on their own, a mechanical lifting device is needed to ensure safe transfer.
How should an obese patient’s self-consciousness be considered during transport and transfer?
Exposure should be minimized, and the patient should be treated with respect throughout the process.
What positioning considerations should be made for an obese patient on the OR table?
Place a pillow under the knees, secure a safety belt above the knees, and smooth out skin wrinkles to avoid tissue injury.
What challenges might be encountered during intubation of an obese patient?
Intubation can be difficult due to limited mobility of the cervical spine.
Why does anesthesia induction take longer in obese patients?
Decreased pulmonary function leads to slower gas uptake, and higher anesthetic doses are needed due to adipose tissue absorption.
Why does recovery from anesthesia take longer for obese patients?
Fat-soluble anesthetic agents are retained in adipose tissue, and poor blood supply to this tissue slows their elimination.
What steps should be taken to prevent tissue injury when positioning an obese patient?
Smooth out wrinkles, pad tissue folds, and ensure proper padding to prevent pressure injuries and bruising.
What is essential when placing a grounding pad on an obese patient?
Ensure the pad is in full contact with the skin, remove wrinkles, and avoid placing the pad near overlapping skin folds to prevent burns.
What tools are required for surgical procedures on obese patients?
Long instruments, such as needle holders, retractors, and hemostats, are required. The procedure may also take longer than usual.
What are the common post-surgical complications for obese patients?
Increased risk of wound infections, dehiscence, and evisceration. Surgeons may use special closure techniques like Montgomery straps or suture bridges.
What are the three most common complications after gastric bypass or gastroplasty surgery?
Abdominal catastrophes, internal hernia, and acute gastric distention.
Why is diagnosing abdominal catastrophes difficult in obese patients?
Symptoms and complaints are crucial, as signs of infection may not be present in obese patients.
What symptom often indicates peritonitis in gastric bypass patients?
Acute respiratory failure.
What should be done if visceral perforation is suspected in a gastric bypass patient?
An exploratory laparotomy should be performed.
What is a common complication in gastric bypass patients involving internal hernia?
Internal hernias and volvulus, which can cause bowel necrosis if left untreated.
What is the primary symptom of internal hernia or volvulus in gastric bypass patients?
Periumbilical pain.
How is acute gastric distention diagnosed in gastric bypass patients?
An upright abdominal radiograph will show the dilated stomach.
What is the treatment for acute gastric distention in gastric bypass patients?
Emergency laparotomy with insertion of a gastrostomy tube and examination of the jejunostomy.
What complications often occur in obese patients undergoing abdominal surgery, particularly related to gallstones?
Gallstones are commonly found, and the gallbladder may need to be removed during abdominal procedures. The CST should have cholecystectomy supplies ready.
What musculoskeletal complication is common in obese patients, and how is it treated?
Degenerative osteoarthritis in the back, hips, and knees, which may require total joint arthroplasty. In patients over 250 pounds, weight loss may be needed before surgery.
