OBESITY & BARIATRIC SURGERY

Question 1

BMI 25 - 29.9

Answer 1

Overweight

Question 2

BMI 30

Answer 2

Obese

Question 3

BMI >40

Answer 3

Morbid obesity

Question 4

Apple shape, higher risk of cardiac problems, and other obesity complications

Answer 4

Android obesity

Question 5

Pear shape

Answer 5

Gynecoid obesity

Question 6

Type of surgeries that limit the amount of food consumed

Answer 6

restrictive surgeries

Question 7

Types of restrictive surgeries

Answer 7

Laporascopic adjustable gastric band (LAGB)- restricts stomach vol. to 10-15mL

Laporascopic sleeve gastrectomy (LSG)- removes the portion of the stomach that secretes ghrelin, the hormone that stimulates feeling hungry. Up to 85% of the stomach is removed.

Question 8

Types of bariatric surgeries

Answer 8

-restrictive surgeries
-vertical banded gastroplasty
-malabsorption surgeries
-total gastrectomy

Question 9

Malabsorption surgery that interferes w/ absorption of food and nutrients

Answer 9

Roux-en-Y gastric bypass (RNYGB)

Question 10

Surgery that removes the lower esophagus stomach and anastomosis of the esophagus to the jejunum. GERD should be gone, if symptoms return report immediately.

Cancer tx.

Answer 10

Total Gastrectomy

Question 11

Indications for bariatric surgery

Answer 11

-Hx of morbid obesity with unsuccessful attempts
-BMI >40 or BMI >35 with comorbidities such
as htn, t2dm, hf, OSA

Question 12

Pre-op nursing care

Answer 12

-Diet teaching
-Check availability of bariatric bed and mech lift devices
-Pertinent labs: CBC, electrolyte, BUN & CREAT, HbA1C, iron, B12, thiamine and folate.
-SCD for DVT prevention

Question 13

Post-op nursing care

Monitor leak of anastomosis: two ends that have been connected lose seal and contents leak out.

S/sx are

Answer 13

Increased back, shoulder, abd pain, restless, tachycardia, oliguria… EMERGENCY, notify physician.

Question 14

Passage of food into the small intestine occurs too rapidly, causing a surge of insulin to be released

Answer 14

Dumping Syndrome

Question 15

S/Sx of Dumping Syndrome

Answer 15

-Weak, dizzy, tachy
-Epigastric fullness, abd cramps, HYPERactive bowel sounds
diaphoretic , cold and clammy skin
-15-30 mins after eating
-Self-limiting and resolves in about 6-12 months but may become chronic

Question 16

How to prevent Dumping Syndrome

Answer 16

-Give smaller meals at 3 hr interval
-Decrease simple carbs; increase proteins and high-fiber food as tolerated.
-No fluids w/ food. Drink 30-35 mins before a meal or 1 hr after.
-Less concentrated sweets. More fruits high in pectin like peaches, plums, and apples.
-Semi recumbent position during meals. Client may lie down on left side 20-30 mins after meal to delay stomach emptying
-Hypoglycemia may occur 2-3 hrs after meals.