Bariatric Surgery Discussion Question
1. What health risks associated with obesity does Mr. C. have?
High Blood Pressure, Diabetes, Physical Inactivity, Sleep Apnea, Cardiovascular Disease.
2. Is bariatric surgery an appropriate intervention? Why or why not?
According to American Society for Metabolic and Bariatric Surgery (ASMBS). The qualifications for bariatric surgery in most areas include:
- · BMI ≥ 40, or more than 100 pounds overweight (ASMBS, 2017).
- BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease (ASMBS, 2017).
- Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts (ASMBS, 2017).
According to these qualifications he would be a candidate. He has elevated glucose making him at risk of diabetes and abnormal lipid being a risk of cardiovascular disease. He has evidence of high blood pressure and sleep apnea. His BMI is at 47.75.
3. The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.
0600 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)
1000 Mylanta 15ml PO
1100 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)
1500 Mylanta 15ml PO
1700 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)
2100 Mylanta 15ml PO
Ranitidine (Zantac) 300 mg PO, Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL
4. Functional health patterns include
health-perception and management- he has always been heavy and needs help with obtaining correct nutritional structure to help with controlled calories, fats, sodium and sugar as well as increasing regular exercise program.
nutritional – metabolic- He has gained a large amount of weight over last few years. He needs to learn to control food consumption, also increase of activity. recognizing foods with high fats, high sodium, and making better choices.
Elimination- Nothing is mentioned so further assessment should be done. Watch for constipation of loose stools. An increase of fiber to help with constipation. Watch for change in bowels with new medications.
activity-exercise- Having an office job and perhaps no desire to exercise can lead to weight gain. He should increase activity by walking at lunch. Joining an exercise gym.
sleep-rest- He is overweight and has sleep apnea, so sleep is probably restless, so a need of a CPAP to get quality sleep may be a good choice.
cognitive-perceptual- He is able to make his needs known, he works and with known information is able to care for himself
self-perception – self-concept- low self-esteem, feeling that he has always been heavy
role-relationship- He is a single man.
sexuality – reproductive- Needs further assessment
coping – stress tolerance- He may overeat due to stress or low self-esteem. He does watch his sodium intake to help cope with hypertension. He is wanting to change his appearance and enhance his health with a weight loss plan. Recommend exercise to help relieve any stress and help cope with change of lifestyle.
5. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.
1. Patient needs to see a nutritional consult to provide him with a healthy diet. This is important because he needs to learn a healthy pattern before having a surgery. He needs to recognize that his eating patterns are partially responsible for his weight gain.
2. His sleeping needs to be improved. He cannot have a healthy mind when you are exhausted. Adequate sleep can help improve mental status and provide you energy to make lifestyle changes that are necessary.
3. He needs to be educated about his high blood sugar. Again, meeting with a nutrition consult can help in this area. He need to have the appropriate equipment to check his own blood sugar.
4. Patient needs to make sure that he is taking the medications at the appropriate times to benefit his peptic ulcer disease. He also need to make sure that he tells all consults about his medications to avoid adverse reactions with any new medications.
5. Patient needs to continue to watch sodium intake and be educated about other causes of hypertension, like stress and lack of cardio exercise. Recommend his becoming involved in walking or joining a gym.
American Society for Metabolic and Bariatric Surgery (ASMBS). (2017). Patient Learning Center. Retrieved August 28, 2017, from https://asmbs.org/patients/