LAGB Review - All Areas Flashcards Preview

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Flashcards in LAGB Review - All Areas Deck (24)
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0

What are the contraindications for LAGB?

- Autoimmune Conditions
- Lupus, Scleroderma
- Chronic Steroid Use
- Inflammatory Diseases of the GI Tract
- Ulcers, Esophagitis, Crohns Disease
- Severe Cardiopulmonary Disease
- Portal Hypertension
- Esophageal/Gastric Varices
- Advanced Cirrhosis
- Psychological Impairment
- Active Addictions

1

What are the Dietary Advancement Phases after LAGB?

Phases:
- Clear Liquids due to inflammation from surgery
= 2 days - 1 week
- Full/Pureed Liquids
= 1 week to 4 weeks
- Soft Foods
= 2 - 4 weeks
- Regular diet

2

What are the signs that a LAGB patient is in the Optimal Zone?

- Early and prolonged satiety
- Small meals satisfy
- Satisfactory weight loss or maintenance

3

What are some common ways to prevent LABG complications, or reduce long term effects of complications?

- Early recognition and treatment is essential
- Peri-Operative anti-coagulation is important
- Prevention of post-operative complications are the responsibility of the entire healthcare team

4

What is the most common cause of litigation with bariatric surgery?

- Failure to recognize and/or treat complications.

5

LAGB dehydration is handled how?

- Determine the reason and treat
- Remember insensible fluid loss
- eg. Hot weather and exercise = increased fluid loss

6

How is band prolapse/slippage diagnosed?

- Diagnosis is usually confirmed with Barium Swallow

7

What is the first step with band slippage treatment?

- Remove the fluid from the band

8

If the prolapse/slippage is a concentric dilation, is small and the symptoms improve, what is the treatment process for the patient?

- Re-train the patient - Behavior modification and eating rules
- Re-adjust the band slowly

9

If the prolapse/slippage is large, what are the treatment options?

- Revision surgery
- Band reposition
- Band removal and replacement
- Conversion to GB, Sleeves, DS

10

What are the signs and symptoms of an obstruction, in a LAGB patient?

- Food and liquid intolerance
- Substernal pain
- Nausea/Vomiting
- Reflux

11

How is an obstruction diagnosed, in a LAGB patient?

- Diagnosis is by UGI and or EGD

12

What is the treatment for an obstruction in a LAGB patient?

- Decompress the band and treat the cause

13

What types of foods may LAGB patients have difficulty with?

- Doughy, sticky foods like bread, dried fruits
- Pasta, Rice, chips
- Raw vegetables - instruct patient to chew thoroughly, Use caution with stringy, fibrous vegetables like celery, pineapple, asparagus
- Caution with nuts
- Dry foods difficult to digest, and can form a bolus in the pouch

14

What are the signs and symptoms that a LAGB patient needs a fill?

- Hungry
- Eating big meals
- Looking for food
- Satiety that does no last beyond 2 hours

15

What are the signs and symptoms that a LAGB is Too Tight?

- Reflux
- Weight gain, maladaptive eating
- Vomiting
- Chest pain with food/fluids
- Increased hunger
- Increased saliva

16

What is the treatment for a LAGB that is too tight?

- Deflate the band according to tolerance and re-educate

17

What are the potential nutritional deficiencies with LAGB patients?

- Reduced micronutrient absorption =
- B1 - Thiamin reduction due to eating less fortified breads and cereals
- Folate - reduction due to eating less volume of fruits and vegetables
- Reduced food intake and reduced volume also effect these nutrients

18

What are the LABG Supplement Recommendations per ASMBS?

- Multivitamin - 100% DV for at least 2/3 of nutrients - 1 per day
- Calcium - 1500 mg/day - divided into 3 doses (no more than 500-600mg per dose at a time)
- B-Complex - optional 1 per day
- Iron - none additional
- Vitamin D - no current recommendation
- Protein - no current recommendation

19

What are the signs and symptoms of a DVT?

- Throbbing, aching, heavy sensation in the calf
- Redness, swelling, warmth
- Leg pain with activity
- Homan's sign is not reliable

20

What is the treatment for a DVT?

- Best Treatment is prevention
- Compression stockings
- Walking
- Anticoagulants

21

What are the signs and symptoms of a PE (Pulmonary Embolism)?

- Shortness of breath
- Chest Pain
- Hypoxia
- Anxiety
- Tachycardia

22

What do you do if you suspect a PE?

- Immobilize the patient
- Start supplemental O2
- Call physician immediately

23

What are the LAGB specific complications?

- Death
- Access Port and Tubing Problems
- Port Infection
- Wound Infection
- Dehydration
- Slippage/Prolapse/Pouch Dilation
- Erosion
- Perforation
- Obstruction