Obesity

Question 1

Pathophysiology of Obesity

Answer 1

Obesity is a chronic, relapsing disease
characterized by an excessive accumulation
of body fat and weight gain.

Question 2

Bariatric Patients

Answer 2

● Socially marginalized
● Judged
● Unsupported
● Stigmatization by HCP’s
○ Including nurses

Question 3

Bariatric Patient Concerns

Answer 3

● Obstructive sleep apnea
● Circulation
● Pharmacokinetics / Pharmacodynamics
● Skin
○ Turn q 2 hours

Question 4

Pharmacological Therapy

Answer 4

● Orlistat
● Phentermine

Question 5

Bariatric Surgery

Answer 5

● Selection criteria: Table 42-6
● Roux-en-Y gastric bypass
● Gastric banding (lapband)
● Sleeve gastrectomy
● Biliopancreatic diversion with duodenal switch

Question 6

Pre-surgical Counseling

Answer 6

Because bariatric surgery involves a drastic
change in the functioning of the digestive
system, patients need counseling before
and after the surgery.

Question 7

Bariatric Surgery: Nursing
Interventions

Answer 7

● Ensure dietary restrictions
● Reduce anxiety
● Relieve pain
● Ensure fluid volume balance
● Prevent infection / anastomotic leak

Question 8

Bariatric Surgery: Nursing
Interventions

Answer 8

● Ensure adequate nutritional status
● Support body image changes
● Ensure maintenance of bowel habits
● Monitor and manage potential
complication

Question 9

Post-Surgical Concerns

Answer 9

● VTE
● Bile Reflux
● Dumping Syndrome
● Dysphagia
● Bowel/Gastric Outlet Obstruction

Question 10

Post-Surgical Education

Answer 10

● Nutrition
● Pain Management
● Physical Activity
● When to Call
● Drains
● Meds to Avoid
● Follow-Up

Question 11

Assessment
overweight:
Obese:
Sever/extreme obese:

Waist circumference:

Answer 11

Height and weight to determine BMI
o Overweight = BMI 25 to 29.9
o Obese = BMI exceeding 30
o Severe/extreme obese = BMI exceeding 40
❖ Waist circumference >35 in women and > 40 in men =
greater risk for obesity
❖ Hip to waist ratio
❖ Lab studies: cholesterol, triglycerides, fasting blood
glucose, HA1c, liver function tests

Question 12

Bariatric Surgery

Answer 12

❖ Results in weight loss of 10% to 35% body weight within
2 to 3 years
❖ Improvement in comorbid conditions
❖ Selection by multidisciplinary team
❖ Selection criteria has changed to include BMI of 30 for
patients with comorbid conditions
❖ Surgery is performed only after nonsurgical methods
have failed

Question 13

Nursing Care of the Patient Undergoing
Bariatric Surgery: Nursing Diagnosis

Answer 13

❖ Deficient knowledge about the dietary limitations during
the immediate preoperative and postoperative phases
❖ Anxiety related to impending surgery
❖ Acute pain related to surgical procedure
❖ Risk for deficient fluid volume related to nausea, gastric
irritation, and pain
❖ Risk for infection related to anastomotic leak
❖ Imbalanced nutrition: less than body requirements
related to dietary restrictions
❖ Disturbed body image related to body changes from bariatric
surgery
❖ Risk for constipation and/or diarrhea related to gastric
irritation and surgical changes in anatomic structures from
bariatric surgery

Question 14

collaborative Problems and Potential
Complications

Answer 14

❖ Hemorrhage
❖ Venous thromboembolism
❖ Bile reflux
❖ Dumping syndrome
❖ Dysphagia
❖ Bowel or gastric outlet obstruction