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89 Cards in this Set

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What percent of American adults are either overweight or obese?
65%
_______is the 2nd leading cause of unnecessary deaths each year.
obesity
What is the goal of healthy people 2010?
-reduce % of obese adults to 15%
-develop measure to prevent excess weight and obesity
is obesity an epidemic or pandemic?
epidemic
A BMI greater than 30 is:
obese
4 causes of obesity?
diet
exercise
drugs
familial & genetic factors
BMI greater than 25 is considered:
overweight
How is BMI calculated?
dividing wt in kg by height in meters squared
BMI greater then 40:
morbidity obese
Co morbid conditions of obesity regarding Urinary system: (3)
-stress incontinence
-gout
-renal disease
Comorbities of obesity regarding Integument status: (3)
-Cellutitis
-fungal skin infections
-panniculitis
Comorbities of obesity regarding endocrine system: (2)
-diabetes type 2
-pancreatitis
Comorbities of obesity regarding the digestive system: (3)
GERD
Gallbladder disease
nonalcoholic steatohepatitis
Comorbities of obesity regarding the cardiovascular system: (6)
-chronic venous insufficiency
-htn
-hyperlipidemia
-artherosclerosis
-dvt
-pvd
Comorbities of obesity regarding the nervous system: (3)
carpal tunnel
stroke
pseudotumor cerebri
Comorbities of obesity regarding the musculoskeletal system: (4)
-osteoarthritis
-rheumatoid arthritis
-sever's disease
-vertebral disc herniation
Comorbities of obesity regarding the reproductive system: (7)
-infertility
-menstrual abnormalities
-pregnancy abnormalities
-hirsutism
-impotence
-polycystic ovarian disease
-neural tube birth defect
diet therapy should be a collaborative effort b/n:
client
physician
dietician
_______suppress appetite, which reduces food intake and over time may result in weight loss
anorectic drugs
Co morbidities of obesity regarding the immune system: (2)
-cancer (breast, colon, prostate)
-poor healing of wounds & infection
co morbid conditions of obesity regarding the psyche: (4)
low self esteem
depression
isolation
disturbed body image
3 ways to surgicall manage obesity:
lipo
panniculectomy
bariatric surgery
4 complementary and alternative therapy for obesity:
acupuncture
acupressure
ayurvedic
hypnosis
surgical procedure used to reduce the amount of adipose tissue in selected areas of the body
liposuction
the excision of an apron of abdominal subcutaneous fat that lacks adequat supportive tissue from people who are morbidly obese
panniculectomy
when was gastric bypass developed?
1960's
approximently how many gastric bypass surgeries were done in 05'?
140,000
kuzmak developed _________ in 1986
the lap band
intraop complication of the lap band:
hemorrhage
after gastric bypass surgery, the new stomach can only hold how much?
1/2 cup
s/p gastric bypass diet
water only
clear liq
full liq
pureed foods
reg. food
drug therapy is an option for those clients w/a bmi of ___ or a BMI of __ with comorbidities.
30
27
what are some ways to non surgically manage obesity? (6)
-diet programs
-diet therapy
-exercise program
-drug therapy
-behavioral tx
-complementary and alternative therapies
___% of dieters regain the weight they've lost within ___ years
85
5
who qualifies for obesity surgery?
bmi >40 or...
bmi 35-39.9 w/serious medical conditions.
s/p gastric bypass diet
water only
clear liq
full liq
pureed foods
reg. food
drug therapy is an option for those clients w/a bmi of ___ or a BMI of __ with comorbidities.
30
27
what are some ways to non surgically manage obesity? (6)
-diet programs
-diet therapy
-exercise program
-drug therapy
-behavioral tx
-complementary and alternative therapies
___% of dieters regain the weight they've lost within ___ years
85
5
who qualifies for obesity surgery?
bmi >___ or...
bmi __-____ w/serious medical conditions.
40
35-39.9
With surgery, the obese client is more at risk for:
pulmonary, thromboembolic complications and death
Whats the most common gastric bypass surgery in the US?
roux-en-y

(rygbp)
with gastric bypass surgery, half the weight loss occurs:
in the first 6 months.
with gastric bypass surgery, weight loss peaks at:
18-24 mo
adjustable silicone band lined with an inflatable balloon
lap band
the lap band restricts:
food intake
Balloon connected to a small reservoir that is placed under the skin of the abd.
lap band
how many degress should the hob be elevated during the post op period from lap band surgerY?
30
when should you drink liquids?
between meals not with meals.
how many meals should you eat a day?
3-6 small meals
_______ is key in maintaining weight loss
physical activity
pre op evaluations for obesity sugery (4)
medical clearance
surgical eval including gastroscopy
nutrition consult
psych consult
behavioral tx for the obese clients
-self monitoring techniques
-stimulus control
-reinforcement techniques
-cognitive restructuring
what are some good reasons to get laparoscopic gastric bypass? (7)
-less blood loss
-shorter hospital stay
-less post op pain
-less pulmonary complications
-fast recovery
-fewer would complications
-better cosmesis
-better wt. loss than after purely restrictive procedures
-low incidence of protein-calorie malnutrition and diarrhea
-rapid improvement or resolution of wt. related comorbidities
-appetite reduction

are all:
advantages of RYGBP
early complications of RYGBP: (7)
-anastomosis leak
-pulmonary embolism
-wound infection
-gi hemorrhage
-resp. insuff.
-mortality
Late complications of RYGYP: (6)
-incisional hernia
-bowel obstruction
-internal hernia
-stoma stenosis
-micronutrient deficiencies
-marginal ulcer
strict compliance, freq. follow up for band adjustments
lap band
late complications of lap band surgery
band erosion into stomach
esophageal dilation
failure to lose weight
post op complications of lap band surgery:
-band slippage
-leakage of the balloon or tubing
-port infection
-band infection
-obstruction
-n/v
what are the advantages of lap band surgery? (8)
-absence of anemia
-absence of dumping
-lack of malabsorption
-short hosp. stay
-very low mortality rate
-adjustability of band
-reversibility
-laparoscopic placement
how often should you monitor vital signs post operatively with lap band surgery?
q2-4h
how often should the patient, tubes and catheters be repositioned after lap band surgery?
q2h
how long can a pt. have a pca after lap band surgery?
24-48hrs.
whats important regarding bed rails in the post op lap band pt.?
they shouldn't be touching the clients body and they should be wide enough to allow client to turn
whats important about ngt post operatively in the lap band pt.?
an ngt may be in place, never reposition the tube
what are some post op nsg care suggestions for the lap band pt?
c
db
leg exercises
early ambulation
what are some signs and symptoms of dumping syndrome?
tachycardia
nausea
diarrhea
abd cramping
in the lap band client, you should use absorbant padding:
between folds
in the post op lap band client, you should observe skin and folds for:
redness
excoriation
breakdown
the post op lap band client most likely will be wearing what?
abd binder
why should you avoid chewing gum?
it could block the stomach outlet if swallowed
what kinds of sweets should you avoid?
concentrated
what are some co morbid cardiovascular conditions that are improved ater surgery?
-chronic venous insuff
-htn
-hyperlipidemia
what are some co morbid digestive conditions that are improved ater surgery?
gastroesophageal reflux disease
what are some co morbid endocrine conditions that are improved ater surgery?
diabetes type II
what are some co morbid musculoskeletal conditions that are improved ater surgery?
-degenerative joint disease pains
-hiatal hernia
-low back pain
what are some co morbid nervous system conditions that are improved ater surgery?
-pseudotumor cerebri
what are some co morbid reproductive conditions that are improved ater surgery?
-infertility
-menstrual abnormalities
-pregnancy abnormalities
what are some co morbid respiratory conditions that are improved ater surgery?
-asthma
-obesity hypoventilation syndrome
-sleep apnea
what are some co morbid urinary system conditions that are improved ater surgery?
-urinary stress incontinence
-levels of uric acid
aerobic exercise should:
begin slow and increase in intensity
what type of intensity and duration exercise program is good?
low intensity, short duration
what are some diets?
weight watchers
atkins
jenny craig
fasting
grapefruit
hollywood
senoma
if someone tried other methods of weight loss and are still severly obese, do they qualify for surgerY?
yes
if someone is unable to physcially perform routine daily activities and your quality of life is seriously impaired due to the severity of obesity
they qualify for surgery
in order to qualify for obesity surgery, the pt. must understand:
procedure
risks of surgery
effects after surgery
in order to qualify for obesity surgery, the pt. must be motivated to:
make a lifelong behavioral commitment-diet and exercise
RYGBP has proven to result in durable:
wt. loss and improvement in weight related medical illnesses.