Obesity Lecture Notes

Flashcards about Obesity

BMI (kg/m2) =

Weight (kilograms)/Height (meters)2

Underweight BMI

Less than 18.5

Normal weight BMI

18.5–24.9

Overweight BMI

25.0–29.9

Obesity (class 1) BMI

30.0–34.9

Obesity (class 2) BMI

35.0–39.9

Extreme obesity (class 3) BMI

Greater than 40.0

Highest prevalence by ethnicity

Non-Hispanic blacks 49.6%

BASAL METABOLIC RATE:

The majority of energy expenditure is in the form of basil metabolism, or the amount of energy required to maintain vital organ function

Most accurate way to measure body fat

Underwater weighing

Orlistat

Inhibits, pancreatic, lipase and reduces dietary fat absorption. Side effects include increase, flatus loose, and oily stools, cramping, and nausea.

Lorcaserin

Affects chemicals in the brain that help regulate appetite and increase the Feeling a fullness so less food is eaten. Side effects include headache, dizziness, fatigue, constipation, dry, mouth mouth. Associated with patients with severe depression and cardiac or valvular disease.

Phentermine/topiramate

Suppress appetite for up to 12 weeks. Decreased appetite enhanced safety Side effects include alter, taste, numbness, tingling, insomnia, dizziness, and anxiety may cause birth effects and females so reliable, birth control and pregnancy test on monthly basis with treatment

Bupropion-naltrexone

Second option in treatment of obesity, used adjunct to diet and exercise with BMI greater than 30. It contains bupropion and antidepressant And FDA recommends counseling and patient patients ages 18 to 24 at risk for suicidal ideations

Liraglutide

Only FDA approved medication injectable for weight loss. Used with reduced Calorie diet and increased physical activity. Contraindicated impatience with medullary thyroid cancer.

Restrictive:

Gastric band, gastric sleeve, gastric plication

Short term, life-threatening complications include

Pulmonary Embolism,, Infection ,Anastomosis

Long-term complications

Band slippage, Obstruction ,Hernia, Esophageal erosion, Ulcers, Acid reflex Vitamin deficiency, Osteoporosis, Anemia, Dumping syndrome-Nausea, vomiting, abdominal pain, cramps, diarrhea, lightheadedness, dizziness, bloating, belching, fatigue, heart, palpitations, rapid heart rate

B head of the bed elevated 30 to 45°

Obesity, hypoventilation syndrome

Ms. Wiley is 5 ft 6 in. tall and weighs 256 lb. The nurse calculates her BMI to be which value? A. 19 kg/m2 B. 34 kg/m2 C. 41 kg/m2 D. 49 kg/m2

41 kg/m2

Ms. Wiley asks if she qualifies for bariatric surgery. What is the best response by the nurse? A. “No. You are healthy and therefore do not qualify for bariatric surgery.” B. “Yes. You meet the BMI criteria, but I would not recommend bariatric surgery for someone so young. I know someone who died from it.” C. “No. You do not meet the BMI criteria for bariatric surgery.” D. “Yes. You meet the BMI criteria, but there are several other factors that determine whether someone should have bariatric surgery.”

“Yes. You meet the BMI criteria, but there are several other factors that determine whether someone should have bariatric surgery.”

Ms. Wiley wants to know the key difference between the Roux-en-Y and adjustable gastric banding. Which explanation by the nurse is most accurate? A. “Some surgeons just prefer one over the other.” B. “Roux-en-Y is a combination of a restrictive surgery and a malabsorptive surgery.” C. “Adjustable gastric banding is designed to be temporary.” D. “Roux-en-Y is a type of adjustable gastric banding.”

“Roux-en-Y is a combination of a restrictive surgery and a malabsorptive surgery.”

The nurse is caring for Ms. Wiley in the presurgical suite. The patient asks, “Will you hold my hand? I am getting nervous. My mom told me this morning that I could die from this surgery.” Which action by the nurse is best? A. Patting the patient on the shoulder and covering her up B. Asking her if she would like some alprazolam (Xanax) to calm her down C. Holding her hand and listening to her concerns D. Explaining that the percentage of people who die from bariatric surgery is small

Holding her hand and listening to her concerns

The nurse is caring for Ms. Wiley in the post- anesthesia recovery unit. The patient is 2 hours post–gastric bypass surgery and has a nasogastric tube (NGT). The orders state that the NGT should be hooked up to low continuous suction. There is scant blood-tinged drainage coming from the tube. What action should the nurse take? A. Call the surgeon right away. B. Reposition the NGT. C. Discontinue the NGT. D. Document the findings.

Document the findings.