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Presentation on theme: "Obesity."— Presentation transcript:

1 Obesity

2 Obesity and Overweight
Obesity is an abnormal increase in the proportion of fat cells Primarily occurs in the visceral and subcutaneous tissues of the body Second leading cause of preventable death Third leading reason for liver transplantation

3 Classification of Body Weight and Obesity
Body mass index (BMI) – see chart, p. 945 Waist circumference People with excessive visceral fat in waist are more prone to cardiovascular disease and metabolic syndrome Waist-to-hip ratio (WHR) Waist measurement is divided by hip measurement A WHR measurement >.08 is at risk for complications

4 Body Mass Index What is considered to be normal BMI?
What is classified as overweight? What is considered obese?

5 Waist Circumference Health risks increase if the waist circumference is >____ in a female and >____ in a male?

6 Classification of Body Weight and Obesity
Body Shape Pear shape have more sub-q fat Most fat is below the waist

7 Apple Shaped Body Apple shape have more visceral,
abdominal fat and are prone to: Elevated triglycerides Metabolic syndrome Decreasing insulin sensitivity High levels of HDL cholesterol Increasing blood pressure Release of more fatty acids into the bloodstream

8 Etiology and Pathophysiology
Genetic/Biologic basis Environmental factors Psychological factors

9 Health Risks Associated with Obesity
Problems occur at higher rates for obese patients Mortality rate rises as obesity increases Especially with increased visceral fat Obese patients have a decreased quality of life Most conditions improve with weight loss

10 Health Risks Associated with Obesity

11 Metabolic Syndrome Also know as Insulin Resistance
Diagnostic Criteria: Increased Waist circumference Elevated Triglycerides Elevated HDL Elevated Blood Pressure Fasting Blood Glucose > 110mg/dl These people are at risk for heart disease, stroke, Diabetes, renal disease

12 Goals of Care Modify eating patterns
Participate in a regular physical activity program Achieve weight loss to a specified level Minimize or prevent health problems related to obesity

13 Treatment and Nursing Care

14 Start with Behavior Modification
Patient must be ready for change in their lifestyle

15 Treatment and Nursing Care
Nutritional Therapy Low calorie with adequate amounts of fruits and vegetables, bulk, and meets daily vitamin requirements Avoid fad diets Small Portions Exercise 30 minutes to 1 hour per day

16 Patients desire to change lifestyle
+ Exercise Diet control Weight Loss

17 Surgeries for Obesity

18 Bariatric Surgery Used to treat morbid obesity
Currently the only treatment found to have a successful and lasting impact for sustained weight loss

19 Bariatric Surgery Must meet all of the following criteria to be considered an ideal candidate BMI ≥40 kg/m2 with one or more obesity-related complication 18 years or older Understands the risks and benefits Has been obese for >5 years Has tried and failed to lose weight

20 Bariatric Surgery Three broad categories Restrictive Malabsorptive
Combination of restrictive and malabsorptive

21 What is different in the
pre-op nursing care for the Obese Patient?

22 Preoperative Care Have room ready for patient prior to arrival making adjustments in equipment and supplies Skin Preparation Teach T,C, DB and exercises IV access

23 Postoperative Care Trained staff should assist transfer of unconscious patient . During transfer ensure that patient’s Airway is stabilized Pain is managed Assess of vital signs. What is of particular concern ? Keep bed at 300 – 450

24 Postoperative Care T,C, DB – being sure to splint incision.
Why is so important? What is a complication if does not splint incision? Pain Management TED hose and pneumatic compression devices

25 Post op complications Rapid oxygen desaturation
Wound evisceration and dehiscence Wound Infection

26 Post –op Complication Dumping syndrome – gastric contents empty too rapidly into the small intestine Symptoms – vomiting, nausea, weakness, sweating, faintness, and diarrhea Prevention – eat small meals; avoid high CHO foods/concentrated sweets and no fluids with meals Iron Deficiency anemia

27 What is the criteria for feeding this Patient? What type of diet are they placed on?

28 Evaluation Expected outcomes Long-term weight loss
Improvement in obesity-related co-morbidities Integration of healthy practices into lifestyle Monitoring possible adverse side effects Improved self-image

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