Surgery For Obesity

Question 1

Bariatic surgery is?

Answer 1

Surgery on the stomach or intestine to help person with extreme obesity lose weight

Question 2

What is the 2 criterial for sugary

Answer 2

BMI > 40
BMI > 35 with 1 or more obesity related complications
( hypertension, type 2, heart failure, sleep apnea )

Question 3

Before going into a bariatric surgery, the patient must be screen for? (2)

Answer 3

All physical, psychological and behavior conditions

Illnesses

Question 4

Bariatric surgery
Categories of surgeries must be done how?

And how do they determine this? (3)

Answer 4

Laparoscopically

Restrictive - size of stomach
Malabsorption - length of small intenstine

Combination of both ^

Question 5

What are the 3 surgeries?

Answer 5

Restrictive adjustable gastric banding
Vertical sleeve
Combination of restrictive and malabsorption

Question 6

Restrictive surgery / adjustable gastric banding
It’s the most common? True or false

How does it work?

It’s also connected to a subcutaneous port that can be inflated or deflated to meet patients?

Answer 6

True

Limits stomach size with an inflatable band around fundus of the stomach

Weight loss

Question 7

What is a vertical sleeve gastrectomy?
How much % removed ?
Is it reversible?
While the stomach is drastically reduced in size, the function is still?

Results in?

Answer 7

Sleeve shaped stomach
85% stomach removed

No

Preserved

Elimination of hormone produced in the stomach that stimulate hunger

Question 8

Combination of restrictive and malabsorption surgery
Roux en Y surgical procedure

It has a low?
Great patient?

Food bypasses ___% of the stomach, duodenum and small segment of jejunum

Answer 8

Complications rate
Tolerance
90%

Question 9

What is a complication of RYGB surgery?

Answer 9

Dumping syndrome

Question 10

What is dumping syndrome?

Answer 10

Gastric contents empty too rapidly into the stomach intestine

Question 11

Patients are discouraged from eating what to avoid dumping syndrome?

Answer 11

Sugary foods

Question 12

Dumping syndrome is also an issue in absorption, so patients may end up becoming?

Answer 12

Iron deficiency anemia

Question 13

Preoperative care
We as nurses want to determine if the patient is using any?
There ___ information
That will indicate ^

A team may come in order to assess the patient ; examples

You want to have to room prepare how?

Answer 13

Devices
Health
( risk of complications & co morbitidies)

Cardiologist, gynecologist, gastroenterologist

Larger blood pressure cuff
Large gown
Wheelchair

Question 14

Before going into the surgery, you want the patient to be what?
As well teach the use of 2 things?

Answer 14

Coughing, deep breathing and turning

Incentive spirometer
Cpap

Question 15

Post operative care
We want to closure observe for?
Transfer with specially trained personnel by (3)

We lastly want to evaluate for re sedation ( why? Or how?)

Answer 15

Complications

Stabilize airway
Manage pain
Elevate head 30-45

Anesthesia stored in adipose tissue

Question 16

We want the patient to especially be doing what after post op?
This helps prevent?

Answer 16

Turning and ambulating

Pneumonia, DVT, infection

Question 17

Special considerations post op care is?
What do we want to do (5)

Answer 17

Abdominal pain

Medicate as needed
Anastomosis leaks may cause pain
Evaluate wound condition closely
Attentive to placement of NG tube
Careful transition to new diet

Question 18

Ambulatory and home care
We want the patient to follow?

Answer 18

Nutrition diet!!

Question 19

Patients are normally discharge within how many days on full liquid diet?

Answer 19

10-14 days

Question 20

We always want the patient to come for long term follow up in order to help with? (3)

Answer 20

Physical and psychological reasons
( old diet patterns, issues in fertility, new body image )

Question 21

Cosmetic surgeries can be given to obese patients once they meet? (2)

Answer 21

Achieved weight reduction
Excess skin folds and fat

Question 22

Two cosmetic surgeries are ?

Answer 22

Lipectomy
Liposuction

Question 23

Evaluation of obesity?
( we also want to monitor for possible )

Answer 23

Weight loss!!!
Adverse effects

Question 24

Gerontological considerations
They have increase?
Because (5)

Answer 24

Prevelance of obesity
- decrease energy
- age related problems
- decrease mobility, Incontience, hypoventilation, sleep apnea
- decrease quality of life
- decrease life expectancy by 6-7 years

Question 25

metabolic syndrome is known as (3)?
( other names )

Answer 25

Syndrome X
Insulin resistance
Dysmersbolic syndrome

Question 26

Metabolic syndrome is what?

Answer 26

Collection of risk factors that increase an individuals chance of developing cardiovascular disease, stroke, diabetes mellitus

Question 27

What can we do to help diganosis or treate metabolic syndrome?

TRIGLYCERIDES
HDL ( men & women )
BP
FASTING FKUCOSE

Answer 27

Waist circumstances in men
> 40 woman > 35

> 150
<40 men <50 women

> 130/85

> 100

Question 28

How does metabolic syndrome work?

Answer 28

Insulin resistance is due to excessive visceral fat

Question 29

Metabolic syndrome increase prevalence of coronary artery disease and what else (3)

Answer 29

Hypertension
Increased risk for clotting
Abnormal cholesterol level

Question 30

What is the first line metabolic syndrome intervention?

And it’s followed by (4)

Answer 30

Life style!!

Reduce LDL
Stop smoking
Lower BP
Reduce glucose levels