PERIOPERATIVE NURSING CARE OF THE MORBIDLY OBESE PATIENT

SAFETY CONCERNS & SPECIAL EQUIPMENT HIGH BMI/ BARIATRIC PATIENT HAVE RIGHT TO BE TREATED W/ COMFORT, DIGNITY, RESPECT & PRIVACY CULTURE OF SAFETY FOR BOTH PATIENTS AND CAREGIVERS IDENTIFY MECHANICAL LIFTING EQUIP & APPPROVED PATIENT HANDLING TECHNNIQUES.

ASSESSMENT OF HIGH BMI/ BARIATRIC PT SENSITIVE TO PATIENT PERCEPTION- BEDS, GURNEYS, WHEELCHAIRS THAT FIT TALK TO THEM ABOUT WHAT TO EXPECT ASSESS AS ALL PATIENTS PLUS: GERD/CIRCULATION/ RESPIRATORY HIATAL HERNIA, SLEEP APNEA, ABDOMINAL GIRTH/JOINT ISSUES ANESTHESIA – WEDGE/ DIFFICULT INTUBATION CART DVT PREVENTION PHYSICAL ASSESSMENT CO-MORBIDITIES: DIABETES/ CAD

ROOM PREPARATION/ POSITIONING OR BED CAPACITY IN SPECIFIC POSITION STANDARD (1000#)/ REVERSE (#500) SAFETY STRAPS, GENERALLY AT LEAST TWO SETS TRANSFER SYSTEM ALREADY ON BED AWARE OF ANESTHESIA NEEDS US DOPPLERS GLIDE SCOPE LINE PLACEMENT WEDGE PILLOW EXTRA PILLOWS, GEL PADDING , EGGCRATE

POSITIONING CONSIDERATIONS SUPINE: ARMBOARD –ULNA/ HYPEREXTENSION/ NEUTRAL POSITION SAFETY STRAPS – THIGHS/ LOWER LEGS PILLOW UNDER KNEES – NEED HEEL PROTECTION REVERSE TRENDELENBERG- FOOTBOARD ARMSLEDS W/ PADDING IF NEED TO TUCK FOLEY INSERTION – GET ASSISTANCE TO ACHIEVE PROPER TECHNIQUE LITH: CANDY CANE – DO NOT LET LEG REST AGAINST POLE CREATIVE SIZING FOR ALLEN STIRRUPS HISTORY OF HIP INJURY/ TOTAL JOINT REPLACEMENT PRONE: LARGE GEL ROLLS/ RESPIRATORY/ PADDING/ PRESSURE POINTS ARMS MOVED CAREFULLY TO NEUTRAL POSITION LATERAL: AXILLARY ROLL/ PADDING/ ALIGNMENT INCLUDING HEAD/NECK PRESSURE POINTS – EAR,SHOULDER, HIP, LATERAL TO TOES

INFLATED PATIENT TRANSFER PAD

ALLEN STIRRUPS

CANDY CANE STIRRUPS

PNUEMATIC LIFT FOR LITHOTOMY

TYPES OF BYPASS

TAKE HOME PROVIDE SUPPORTIVE & RESPECTFUL ENVIRONMENT OF CARE FOR ALL PATIENTS, REGARDLESS OF BMI! IDENTIFY MECHANICAL LIFTING EQUIPMENT AT YOUR INSTITUTION! GET HELP, SAVE YOUR BACK!