Nursing care of the person having bariatric surgery Abstract The increasing incidence of morbid obesity suggests that the quantity of bariatric surgical procedures will continue to multiply each year. Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities.
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Which disorder does the nurse recognize bariatric surgery as a treatment?
The nurse recognizes bariatric surgery as a treatment for which disorder? 1. Anorexia Nervosa 2. Binge Eating 3. Rumination 4. Bulimia Nervosa Ans 2. Rationale Bariatric surgery is an option to treat binge eating disorder as the patients are obese due to overeating, with no compensatory activities such as exercise.
What is the role of practice nurses in bariatric patient care?
Abstract. The increasing incidence of morbid obesity suggests that the quantity of bariatric surgical procedures will continue to multiply each year. Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities. However, quality nursing care and effective patient teaching are essential to …
What is in the literature on bariatric surgery?
May 27, 2016 · The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by non-surgical means.
What are the challenges of being a specialist bariatric nurse?
"Gallstones are a common occurrence in patients who have bariatric surgery." The nurse is caring for a patient with suspected dysphagia. Which action is most appropriate for the nurse to take? Instruct the patient to take practice swallows before the meal. A patient with a gastrostomy tube gets a bolus feeding of 200 mL every 4 hours.
What are complications of bulimia?
- Negative self-esteem and problems with relationships and social functioning.
- Dehydration, which can lead to major medical problems, such as kidney failure.
- Heart problems, such as an irregular heartbeat or heart failure.
- Severe tooth decay and gum disease.
Which physical finding supports a diagnosis of anorexia nervosa?
Which patient type is considered the most likely to suffer from anorexia nervosa?
What are the common characteristics of bulimia nervosa select all that apply?
What is the most successful treatment for anorexia nervosa?
For adults, cognitive behavioral therapy — specifically enhanced cognitive behavioral therapy — has been shown to help. The main goal is to normalize eating patterns and behaviors to support weight gain.Feb 20, 2018
How is the diagnosis of anorexia nervosa determined?
What is the difference between anorexia nervosa and bulimia nervosa?
Who is affected by bulimia?
Who suffers from anorexia?
Which of the following is a common treatment of bulimia?
What is bulimia nervosa characterized by?
How do you diagnose bulimia nervosa?
- Talk to you about your eating habits, weight-loss methods and physical symptoms.
- Do a physical exam.
- Request blood and urine tests.
- Request a test that can identify problems with your heart (electrocardiogram)
- Perform a psychological evaluation, including a discussion of your attitude toward your body and weight.
What is weight loss surgery?
Weight-loss surgery, also known as bariatric surgery, is an operation that makes changes to the digestive system. It is intended for people who are obese and need to lose weight but have not been able to do so through other means.
What is the National Institute of Diabetes and Digestive and Kidney Diseases?
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
What is the digestive system made of?
The digestive system is made up of the gastrointestinal (GI) tract —also called the digestive tract—and the liver, pancreas, and the gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. Next: Definition & Facts.
What is the goal of anorexia treatment?
Verbalizing a realistic body image and improved self-concept are important goals, but nutritional integrity is a higher priority. The goal of treatment is to achieve independence with decision-making processes.
How to teach a patient to avoid binge purge?
Learning about scheduled balanced meals can help the patient to maintain a steady dietary regimen and avoid binge-purge cycles. Identifying trigger foods can be done by encouraging the patient to explore ideas about trigger foods. Including forbidden foods can be achieved by discussing the patient's irrational thoughts regarding those foods. Health effects of purging can be taught by educating the patient about the ill effects of induced vomiting.
How much does anorexia nervosa weigh?
adolescent patient diagnosed with anorexia nervosa currently weighs 97 lbs. The patient's ideal body weight is 127 pounds. Identify the highest priority goal for this patient. The patient will:
Why do families need information about eating disorders?
This information can serve as a basis for additional learning about how to support the family member. A patient with bulimia nervosa wants to reduce the feeling of powerlessness .
What is a bariatric nurse?
The specialist bariatric nurse is an integral part of the bariatric MDT, providing support and education to patients and advocating for them, both before and after surgery. The complexity of obesity as a condition – and often the presence of at least two obesity-related comorbidities – means that bariatric patients are generally seen by all members of the MDT from initial referral to discharge. In the MDT, the specialist bariatric nurse acts as the central communication partner for the patient and is often responsible for multidisciplinary referrals, when these are necessary.
What is the role of a nurse in bariatric care?
However, practice nurses are well placed to provide follow-up using a focused biopsychosocial approach, as patients learn to negotiate the processes of living with a body changed by surgery.
What is the role of a specialist nurse in the bariatric MDT?
The role of the specialist nurse in the bariatric MDT needs consensus and operational clarification, perhaps using elements of the US certification programme as models but adapting them to the context of the NHS. Formal communication pathways need to be established between specialist and practice nurses, so patients can transition from hospital to community settings seamlessly and best practice can be shared.
How many bariatric surgeries were performed in 2016?
Bariatric surgery is becoming an established intervention for obesity and obesity-related metabolic disorders (such as type 2 diabetes) in adults, with 5,675 procedures performed in NHS settings in 2016-17 (Welbourn et al, 2014).
How does bariatric surgery affect patients?
Bariatric surgery can have a negative impact on patients’ psychosocial wellbeing, as well as on their physical health status and function (Brown, 2015). To shed light on the complex, and often unmet, support needs of bariatric surgery patients (Graham et al, 2017), we need to involve patients in the co-construction of know-ledge about their lived experience. We need to give them the opportunity to influence the development of care pathways and formal educational programmes (Phoenix et al, 2018; Rowland and Kumagai, 2018; Kaplan et al, 2017). In our view, this would add much to the current system of annual monitoring of nutritional status, where there are no key mechanisms for understanding and supporting the holistic patient experience.
What is the focus of nursing?
Nursing already has a clear focus on compassionate care and the need to integrate patient and carer perspectives into values-based learning for professionals in the discipline; this provides an additional opportunity for specialist care in bariatric surgery for patients and their families and carers.
How long after surgery do you have to be discharged to a practice nurse?
Practice nurse’s role. Approximately two years after surgery, patients are discharged to general practice to receive long-term follow-up. The National Institute for Health and Care Excellence (2014) recommends annual monitoring of nutritional status and supplementation.
How does bariatric surgery affect the patient?
Bariatric surgery results in a major lifestyle change for the patient. This change will evolve over time as weight is lost, and the patient adjusts to changes in eating patterns, body image, and the perceptions of others.
What should a nurse do before discharge?
Ideally the nurse, patient, and family should have an opportunity for private education sessions prior to discharge. During the postoperative period, the nurse in the physician's office can serve as a source of information and a monitor of patient progress.
What is the stay in acute care?
The patient's stay in acute care is usually very short. Clearly the patient and family need to go home with specific information about drinking/eating, caring for drainage tubes, skin and wound care, ambulation, self-care, and signs and symptoms that require medical attention.
Is bariatric surgery a morbid procedure?
Nursing care of the person having bariatric surgery. The increasing incidence of morbid obesity suggests that the quantity of bariatric surgical procedures will continue to multiply each year. Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities.
Is bariatric surgery a good way to manage weight?
Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities. However, quality nursing care and effective patient teaching are essential to achieve positive patient outcomes.
Is bariatric surgery an accepted approach to weight management?
The increasing incidence of morbid obesity suggests that the quantity of bariatric surgical procedures will continue to multiply each year. Bariatric surgery has become an accepted approach to weight management with the additional benefit of resolution of several co-morbidities.
What are the requirements for bariatric surgery?
Specific criteria regarding designation of the failure of medical therapy have not been formalized but generally include treatment in a variety of medically supervised settings. An understanding or insight into the pathogenesis of obesity and the requirement to reduce energy intake substantially if major weight loss is to be achieved is a requisite7. Candidates for bariatric surgery must be assessed for appropriate surgical risk, including the presence of cardiovascular, pulmonary other system disease and control of these comorbid conditions. These principles apply to surgical procedures in general. It is entirely possible, for example, that patients with an exceedingly high risk profile for cardiovascular disease will have experienced end events that indicate that perioperative risk is excessive and the likelihood of reversing cardiovascular disease by improving the risk profile is unlikely to be successful. However, examples of the most severely obese patients whose perioperative risk may be improved by weight loss include patients with congestive heart failure, related anasarca, respiratory failure and inability to ambulate.
How does bariatric surgery help with weight loss?
The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by non-surgical means. The criteria for surgical intervention were established by a NIH consensus panel in 19911. Failure of medical treatment to accomplish sustained weight loss is common among persons with severe obesity. The biologic factors involved in the limitations associated with maintaining weight loss are powerful2,3. Intense lifestyle intervention can produce averages of approximately 10% at 1 year and maintain weight loss at 5.3% over 8 years. The weight loss accomplished is highly variable but is sufficient to accomplish improvement in medical and comorbidity control4. Pharmacotherapy may enhance short-term as well as longer-term weight loss5. Specific criteria established by the NIH consensus panel indicated that bariatric surgery is appropriate for all patients with BMI (kg/m2) >40 and for patients with BMI 35-40 with associated comorbid conditions. These criteria have held up over the ensuing 24 years to the present, although specific indications for bariatric/metabolic surgical intervention have been identified for persons with less severe obesity, such as persons with BMI 30-35 with type 2 diabetes. The indications for bariatric surgery are evolving rapidly to consider the presence or absence of comorbid conditions as well as the severity of the obesity, as reflected by BMI6.
How long does it take to lose weight after bariatric surgery?
Weight loss following bariatric surgery has been studied and reported both short- and longer-term following all surgical procedures undertaken, as weight loss is the primary objective of bariatric surgery. Mean weight loss is uniformly reported. It is important to recognize, however, the high variability of weight loss following apparently standardized operative procedures such as RYGB or LAGB28. Following RYGB, the LABS consortium reported similar and rapid weight loss 6 months following surgery by stratifying of weight loss into five separate trajectories ranging from 12% total body weight (TBW) loss to 45% TBW 3 years following surgery. Similarly, for LAGB, trajectories are identified for most but not all patients 1 year following surgery. Factors involved in the high degree of variation of weight loss have been examined and reported but do not fully explain the extent of the variability. Predictors of weight loss vary among several reports and include both patient and provider factors. These factors include but are not limited to the presence of specific comorbid conditions such as diabetes, gender, age and behavioral variables, including physical activity and eating behaviors10. Weight loss following RYGB at years 1, 2, and 3 reported in the 30-35% TBW range29. Initial reports of weight loss following LAGB in Australia suggested weight loss was similar to that seen following RYGB. Data from the US as well as Europe, however, have not confirmed comparable weight loss following LAGB, closer to 15.9% TBW at 3 years21. As noted earlier, this lesser weight loss, compared to RYGB, has led to a substantial reduction in the application of LAGB as treatment for severe obesity. The weight loss following biliopancreatic diversion/duodenal switch tends to be slightly greater than that following RYGB while weight loss following sleeve gastrectomy is comparable or is slightly less than RYGB in several reports30-33. Those studies with non-surgical comparator groups, primarily the Swedish Obese Subjects trial and a prospective clinical trial with a population base comparator from Utah, indicate that the non-surgical patients do not experience long-term weight loss. This is not unexpected, given the requirement that patients selected for surgery undergo and fail medical treatment prior to selection for surgical intervention. Longer-term follow-up has been reported by Pories as well as the Swedish and Utah studies. All show rapid weight loss during the first 12 months following RYGB followed by modest regain of weight until approximately Year 3-5. Following Year 3-5, weight loss tends to be maintained in the 30% TBW range34-36. Thus, it is well established that maintenance of weight loss following RYGB at 10-20 years is maintained.
What is the treatment for obesity?
Treatment of Obesity: Weight Loss and Bariatric Surgery
How does metabolic surgery affect hypertension?
The effects of metabolic surgery on the prevalence of hypertension are variable, procedure-related and time-dependent. During the active weight loss phase blood pressure decreases and anti-hypertensive drugs are often discontinued65. However, after weight stabilization the results are less clear, perhaps related to the duration of hypertension pre-operatively. In a systematic review and meta-analysis of 21 studies using a variety of surgical approaches reduced the relative risk of hypertension at intervals between 24-50 months by 46±8% and hypertension risk reached a nadir when BMI was reduced by 10 kg/m2,66. Data from LABS-2 demonstrated that cohort persistent remediation from hypertension at 3 and 6 years was nearly 40%28and the Utah-Obesity study demonstrated a 2 and 6 year relative risk of remission of hypertension of 8.2 and 2.90, respectively67. However, the Swedish Obesity Study revealed recidivism of hypertension at 6-8 years of follow-up with no significant difference from baseline68. Whether or not this relates to permanent changes in the arterial wall based on years of hypertension pre-operatively remains unclear.
What is obesity related comorbidity?
Obesity-related comorbidity is defined as conditions either directly caused by overweight/obesity or known to contribute to the presence or severity of the condition. These comorbid conditions are expected to improve or go into remission in the presence of effective and sustained weight loss.
Is gastric pouch restrictive?
Surgical procedures in the past have been considered to function as restrictive in which the size of the gastric pouch is greatly reduced, malabsorptive in which malabsorption of nutrients contributes to weight loss, and a combination of restrictive and malabsorptive components. It is now clear that this construct is an oversimplification and, to some extent, inaccurate. There is ample evidence that neural and endocrine signaling pathways affecting eating behaviors, reduction of appetite, satiety, energy intake, and possibly physical activity are all operative to a variable extent.
How many meals do post bariatric patients need?
Taking into consideration the different needs of this population, the Johns Hopkins Eating Disorders Program has adapted its protocol so that post-bariatric patients with eating disorders receive six small meals with increased percentages of protein but fewer calories, rather than eating three high-calorie meals per day, says Allisyn Pletch, a clinical nurse specialist in the Eating Disorders Center. They also need to drink fluids between rather than with meals to prevent liquid from filling their pouch and making eating more difficult.
What is binge eating?
Binge eating is associated with a sense of loss of control over eating. "Screening bariatric surgery patients for eating disorders before surgery and careful follow-up are required components of the multidisciplinary approach to bariatric surgery at Johns Hopkins,” Guarda says.
What are the conditions that interfere with physical and psychological health and quality of life?
Others had a pre-existing eating disorder that worsened after gastric bypass . Anorexia nervosa, bulimia and binge eating disorder are serious conditions that interfere with both physical and psychological health and quality of life.
Can eating disorders be treated the same way?
“You can’t treat them the same way,” says Guarda, “because their anatomy has been changed.
Can eating disorders be caused by bariatric surgery?
However, it’s far from clear yet which post-bariatric surgery patients are most at risk of actually developing eating disorders.
What weight reduction drug does a nurse instruct the patient on?
The nurse instructs the patient on the weight reduction drug Orlistat ( Xenical, Alli) that he may experience which side effect(s)? (select all that apply.)
What is the role of a nurse in oral cancer?
The nurse is caring for a patient who is suspected of having oral cancer. When reviewing the patient's health history, which finding provides supportive data for the diagnosis?