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Med-Surg Exam 2 > Bariatrics > Flashcards

Bariatrics Flashcards

1
Q

what is BMI?

A

A measure of nutritional status that does not depend on frame size. Indirectly estimates total fat stores by a height to weight relationship. Clinical scale used to indicate obesity

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2
Q

what does a BMI less than 18.5 indicate?

A

underweight

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3
Q

what does a BMI from 18.5-25 indicate?

A

normal

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4
Q

what does a BMI for 25-29.9 indicate?

A

Overweight

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5
Q

what does a BMI of 30 or higher indicate?

A

obesity

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6
Q

what does a BMI of 40 or higher indicate?

A

morbidly obese

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7
Q

what is another way we predict increased health risk other than BMI?

A

waist circumference
waist-to-hip ratio

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8
Q

what is a healthy waist circumference for men and women?

A

men- <40 inches
women- <35 inches

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9
Q

how is waist to hip ratio calculated?

A

by dividing waist measurements by hip measurements to obtain a ratio

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10
Q

what is an health waist-to-hip ratio for men and women?

A

men- <0.9
women- <0.8
(greater than these values can indicate increased risk)

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11
Q

what are the major complications of obesity?

A

-Cardiovascular and respiratory systems
-Degeneration of the musculoskeletal system
-Increased risk for infection and infectious diseases
-Slower healing processes

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12
Q

almost 80% of obese adults have what diseases?

A

-DM
-dislipidemia
-CAD
-gallbladder disease
-osteoarthritis
(almost 40% of obese adults have 2 or more of these problems)

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13
Q

what are the major (underlined by jenna) risk factors for obesity?

A

*Eating high-fat and high-cholesterol diets
*Genetics & environment
*Behavioral issues
*Physical inactivity

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14
Q

how should blood pressure be taken on a bariatric client?

A

*Correct size blood pressure cuff (avoid inaccurate readings)
*Consider alternative sites for readings (lower leg or wrist)

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15
Q

how should pulse be taken on a bariatric client?

A

*Carotid & femoral pulses are difficult to access
*Consider alternative sites – radial pulse

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16
Q

how should respirations be different for a bariatric client?

A

*Distant lung sounds
*Unable to tolerate lying flat on back
*Consider Bi-pap or C-pap machine use
*Consider ability to ventilate

17
Q

how should you assess weigh of a bariatric client?

A

*Assess equipment capabilities before getting starting
*Accurate readings are essential
*Protect client’s dignity

18
Q

what is a concern regarding a bariatric patients skin related to infection?

A

Moist conditions under skin folds are a great place for yeasts & fungi to grow.
-(Keep skin clean (mild soap and water), rinse well, and dry )

19
Q

what is a concern regarding a bariatric patients skin related to wound care?

A

-Poor circulation
-co-morbid conditions
-malnutrition
-delayed healing

20
Q

how do you asses a bariatric clients GI/Gu compared to a non-bariatric client?

A

-Bowel tones are distant.
-Need to assess close to umbilicus for four quadrants.

21
Q

why might a bariatric client be urinary incontinent?

A

Often r/t decreased mobility due to reluctance or inability to ambulate

22
Q

what are some examples of bariatric equipment?

A

-Ceiling lifts, portable lifts
-large furniture (beds & commodes)
-plus sized gowns
-Gore-Tex sheets
-hover mats
-adequate staff

23
Q

how should you give an IM injection to a bariatric client?

A

Use long needle and a muscle close to the skin (Deltoid)

24
Q

what special considerations should be taken for radiologic imaging of a bariatric client?

A

Always check abdominal girth & weight limits before exams

25
Q

what are the categories of non-surgical treatment options for a bariatric patient?

A

-diets
-exercise
-behavior modification
-medications
-holistic therapies

26
Q

what is important regarding dieting for a bariatric patient?

A

-Generally do not work. Most weight is regained in about 5 years
-Set realistic goals (1 lb./week)

27
Q

what is important regarding exercise for a bariatric patient?

A

-start slow
-make activity an enjoyable habit

28
Q

what is important regarding behavior modification for a bariatric patient?

A

-Learn to identify what triggers overeating
-Lifestyle changes
-This could entail keeping a diary or record of foods eaten; exercise patterns; emotional/situational stimuli for overeating. (Use of a reward system or counseling to help modify negative beliefs.)

29
Q

how is bariatric surgery perceived?

A

-Bariatric surgery is perceived as a last resort to address weight issues, but is the only method with long-term impact on obesity.

30
Q

what are some surgical risks or complications for the bariatric patient?

A

-Wound healing issues
-respiratory issues (PNA)
-pulmonary emboli

31
Q

what is the benefits of bariatric surgery?

A

After bariatric surgery, many patients decrease or eliminate complications of obesity such as DM, HTN, depression, or sleep apnea.

32
Q

what are the two types of bariatric surgery?

A

-restrictive (minimally invasive)
-malabsoptive

33
Q

what are some examples of restrictive or minimally invasive surgery options?

A

-Laparoscopic Adjustable Gastric Banding (LAGB, also reversible)
-Laparoscopic Sleeve Gastrectomy (LSG, can be reversed but not as easily)

34
Q

what is the form of surgery considered malabsorptive?

A

Roux-en-Y gastric bypass (RNYGB) or “gastric bypass”

35
Q

what are the unique needs and risks for the bariatric client post-op?

A

-Priority is airway management immediately post-op (encourage IS use, TCDB!)
-Abdominal binder (to prevent wound dehiscence) including thorough skin management. Encourage splinting (with pillow) when moving to decrease pain.
-Observe for s/s of Dumping Syndrome

36
Q

what is Dumping Syndrome? S/S?

A

-Common post-op complication for bariatric surgery – food is rapidly emptied from the stomach into the small bowel —–(S/S – tachycardia, nausea, abdominal cramps, and diarrhea 10-30 minutes after eating.) Prevention – eating smaller meals and limiting high-sugar foods.

37
Q

what is important for aftercare of surgery for the bariatric client?

A

-Continual dietetic guidance
-Education is needed regarding limiting or avoiding drinking fluids with meals to increase room for more nutrient-dense foods.
-Counseling help with changes in body and relationships
-Cosmetic surgeries to remove excess skin

38
Q

what are the common co-morbidities usually with a bariatric patient?

A

-sleep apnea
-TTDM
-HTN
-CAD
-gallbladder issues (cholecystitis)
-dislipidemia
-osteoarthritis

Med-Surg Exam 2 (4 decks)

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