GENERAL PURPOSE To provide nurses with information about obesity and nursing care for patients undergoing bariatric surgery. LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to:
- Identify criteria for obesity and risks associated with obesity.
- Identify types of bariatric surgery.
- Describe nursing care for patients having bariatric surgery.
1. Your patient's BMI is 30. This is considered
d. extremely obese.
2. All of the following are criteria needed for bariatric surgeryexcept
a. being healthy with a BMI of 40 or greater for at least 5 years.
b. being age 16 or older.
c. not having a treatable disorder that has caused the obesity.
d. having a history of unsuccessful attempts at losing weight by other methods.
3. All of these statements are true for VBG, except
a. the surgeon creates a stomach pouch and anchors it distally by a polypropylene band.
b. the surgeon transects the stomach and attaches the proximal portion to the distal ileum.
c. the surgeon places a vertical line of surgical staples along the lesser curvature of the stomach.
d. VBG makes the patient feel full quickly and slows gastric emptying, so she eats less.
4. When preparing for a patient to arrive for bariatric surgery, you need to know that
a. standard blood pressure cuffs are the right size for most obese patients.
b. standard hospital beds can accommodate patients weighing up to 350 pounds.
c. obese patients should use wall-mounted toilets if available.
d. standard wheelchairs can accommodate patients weighing up to 175 pounds.
5. Which nursing action is the most appropriate for a patient with obesity hypoventilation syndrome?
a. Have the patient lie in a supine position to help her relax while breathing.
b. Keep the head of the bed elevated at a 10-degree angle.
c. Teach her deep-breathing and coughing exercises and incentive spirometry preoperatively.
d. Have her sleep prone.
6. Obstructive sleep apnea is
a. confirmed with a polysomnography study.
b. managed with daily incentive spirometry.
c. not a concern for a patient having bariatric surgery.
d. uncommon in obese patients.
7. While evaluating the patient's fluid balance and vital signs after bariatric surgery, you should routinely
a. restrict I.V. fluids to prevent third-space fluid shifts.
b. assess for signs and symptoms of dehydration and hypovolemia.
c. know that persistent tachycardia over baseline is a normal finding after bariatric surgery.
d. monitor vital signs every 4 hours twice after surgery, then every 8 hours until discharge.
8. After bariatric surgery the patient is at higher risk for deep vein thrombosis because of immobility and
a. altered blood glucose levels from the stress of surgery.
b. increased red blood cell counts from chronic respiratory insufficiency.
c. obstructive sleep apnea complications from decreased oxygen transport.
d. depleted electrolytes from the preoperative bowel-cleaning regimen.
9. Your patient is 1 day postoperative after bariatric surgery. Help prevent complications related to immobility by initially
a. giving her a four-pronged cane and telling her to call if she needs assistance.
b. helping her sit on the side of the bed, then helping her to walk three or more times a day.
c. holding a wheelchair behind her while she walks in the room twice daily.
d. providing her with a walker and instructing her to ambulate once daily.
10. Which statement is correct about skin care following bariatric surgery?
a. Keep the skin folds moist.
b. Extra adipose tissue helps cushion against skin breakdown.
c. Address decreased perspiration from low ratio of body mass to skin area.
d. Provide frequent skin care and daily bathing.
11. If your patient has a red, itchy rash under his panniculus, you should
a. use an antifungal powder as ordered for 14 days to treat the candidal infection.
b. consult a wound specialist because this is the beginning of an atypical pressure ulcer.
c. sprinkle cornstarch in skin folds to decrease the moisture.
d. place a moist dressing between the skin folds.
12. Tell your patient that dumping syndrome
a. can be prevented by taking daily multivitamins.
b. can be treated by eating more simple sugars.
c. causes nausea, weakness, sweating, and diarrhea for up to 90 minutes after eating.
d. occurs only when she eats a high-protein diet that's low in fat and carbohydrates.