Obesity

Question 1

Normal BMI

Answer 1

18.5 - 24.9

Question 2

Overweight BMI

Answer 2

25-29.9

Question 3

What are problematic waist circumference for men and women?

Answer 3

Men over 40 and women over 35

Question 4

Why is an android obesity the shape with the most complications?

Answer 4

Apple-shaped because the fat is located primarily in abdominal area

Question 5

Why is obesity a significant risk factor for cardiovascular disease?

Answer 5

Increase in LDL, Decrease HDL, High triglycerides

Question 6

Obesity hypoventilation syndrome

Answer 6

Reduce chest wall compliance, Increase work of breathing, Decrease total lung capacity

Question 7

Diet teaching for obesity

Answer 7

-Fruits and vegetables, bulk to prevent constipation, sufficient protein
- 1 portion of animal protein = 3 ounces
-1 portion of chopped vegetables = 1/2 cup
-

Question 8

What do you have to be cautious about with dietary teaching to patients?

Answer 8

Watch fluid increase with renal, liver, and heart failure bc they cant have an excess amount

Question 9

Postoperative Care

Answer 9

• HOB at 35-40 degrees
• Fat stores anesthesia = risk for re-sedation
• Diligent turning & ambulation
• Clear liquids then slowly transition
• TCDB
• Teach to use splint
• Incentive spirometer
• Cannot have baby for 12-18 months after surgery

Question 10

What is a complications that can happen postoperative?

Answer 10

Adipose tissue compress chest and abdomen causing CO2 retention causing hypoxemia, pulmonary HTN, polycythemia

Question 11

What is Polycythemia?

Answer 11

Too many RBC > Thick Blood > Increased risk for DVT

Question 12

Metabolic Syndrome Characteristics

Answer 12

Have to have three or more

1. Waist circumference >40 inces (men) & >35(women)
2. Triglycerides >150
3. HDL Cholesterol < 40 (men), <50 (women)
4. BP >130 SBP / >85 DBP
5. Fasting blood glucose >100

Question 13

Adjustable Gastric Surgery Advantages

Answer 13

1. Band can change sizes
2. Absence of dumping syndrome
3. Lack of malabsorption
4. No cutting of stomach

Question 14

Sleeve Gastrectomy

Answer 14

75% of stomach removed

1. Reduces Ghrelin = they won’t feel hungry
2. Function of stomach is preserved
3. Avoids complications of obstruction, anemia, and vitamin deficiencies

Question 15

RYBG (combination of Restrictive & malabsorptive)

Answer 15

1. Better weight loss than restrictive
2. Anemia, Iron deficiency, Cobalamin deficiency, Folic acid deficiency, Calcium deficiency
3. Dumping Syndrome
4. Good long term results

Question 16

Dumping Syndrome

Answer 16

Gastric contents empty too rapidly into small intestine

• Usually happens when drinking liquid w/ food
• Learn to eat w/o drinking
• Avoid surgery food to reduce risk of rebound hyperglycemia

Question 17

Biliopancreatic Diversion (BPD) w/ or w/o duodenal switch

Answer 17

1. Able to eat larger meals than gastric bypass
2. Rapid weight loss
3. Abd bloating, diarrhea, steatorrhea
4. 3/4 loose bowel movements a day
5. Malabsorption of fat soluble vitamins
6. Most complicated weight loss of surgeries

Question 18

Intragastric Balloon

Answer 18

1. Can only be left in for 6 months
2. Doesn’t require invasive surgery
3. Balloon filled w/ saline
4. Outpatient procedure