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Special Nursing Considerations in Caring for the Bariatric Patient

  • James Slattery
Chapter

Abstract

There are several important elements to the nursing care of bariatric patients who present for endoscopic evaluation. Patient safety, comfort, and education are basic nursing responsibilities that have unique features in this patient population. Technical procedural elements and room setup may also be very different in this group of patients, and nurses must be aware of these intricacies. This chapter focuses on important nursing responsibilities in the care of bariatric patients.

Keywords

Obstruct Sleep Apnea Bariatric Surgery Motion Sickness Bariatric Patient Chemoreceptor Trigger Zone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Levitzky BE, Wassef WY. Endoscopic management in the bariatric surgical patient. Curr Opin Gastro-enterol. 2010;26(6):632–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Hignett S, Griffiths P. Risk factors for moving and handling Bariatric patients. Nurs Stand. 2009;24(11):40–8.PubMedGoogle Scholar
  3. 3.
    Zuzelo PR, Seminara P. Influence of Registered Nurses’ attitudes toward Bariatric patients on educational programming effectiveness. J Contin Educ Nurs. 2006;37(2):65–73.PubMedGoogle Scholar
  4. 4.
    Gupta A, Gupta V. Metabolic syndrome: what are the risks for humans? Biosci Trends. 2010;4(5):204–12.PubMedGoogle Scholar
  5. 5.
    Grundy SM. Obesity, metabolic syndrome, and ­cardiovascular disease. J Clin Endocrinol Metab. 2004;89(6):2595–600. Review. PubMed PMID: 15181029.PubMedCrossRefGoogle Scholar
  6. 6.
    Payer J, Jackuliac P, Nagyova M. Obesity and a risk of carcinoma. Vnitr Lek. 2010;56(10):1082–7.PubMedGoogle Scholar
  7. 7.
    Vial M, Grande L, Pera M. Epidemiology of adenoma of the esophagus, gastric cardia, and upper gastric third. Recent Results Cancer Res. 2010;182:1.PubMedCrossRefGoogle Scholar
  8. 8.
    Naito S, Tomita Y, Rha SY, Oemura H, Oya M, Song HZ, Zhong LH, Wahid MI. Kidney Cancer Working Group report. Jpn J Clin Oncol. 2010;40(1): 151–6.CrossRefGoogle Scholar
  9. 9.
    Rosato V, Zucchetto A, Bosetti C, Dal Maso L, Montella M, Pelucchi C, Negri E, Franceschi S, La Vecchia C. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22(4):884–9.Google Scholar
  10. 10.
    Mallampati SR, Gatt SP, Guigimo LD, Desai SP, Freidberger B, Lui P. A clinical sign to predict difficult tracheal intubation; a prospective study. Can J Anesth. 1985;32(4):429–34.CrossRefGoogle Scholar
  11. 11.
    Rocke DA, Murray WB, Rout CC, Gouws E. Relative risk analysis of factors associated with difficult intubation in obstetric anesthesia. Anesthesiology. 1992; 77(1):67–73.PubMedCrossRefGoogle Scholar
  12. 12.
    Sepesi B, Raymond DP, Peters JH. Esophageal perforation: surgical, endoscopic and medical management strategies. Curr Opin Gastroenterol. 2010;26(4): 379–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predictin postoperative nausea and vomiting. Anesthesiology. 1999;91: 693–700.PubMedCrossRefGoogle Scholar
  14. 14.
    Bowen R. Physiology of vomiting. http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/vomiting.html (2010). Accessed Oct 2010.
  15. 15.
    Gan T, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg. 2003; 97:62–71.PubMedCrossRefGoogle Scholar
  16. 16.
    Tramer MR, Reynolds DJM, Moore RA, McQuay HJ. Efficacy, dose response and safety of ondansetron in prevention of post-operative nausea and vomiting: a qualitative systematic review of randomized placebo-controlled trials. Anesthesiology. 1997;87:1277–89.PubMedCrossRefGoogle Scholar
  17. 17.
    Wallenborn J, et al. Prevention of postoperative nause and vomiting by metoclopramide combined with dexamethasone: randomized double blind multicenter trial. Br Med J. 2006;333:324.CrossRefGoogle Scholar
  18. 18.
    Yogendran S, Asokumar B, Cheng DC, Chung F. A prospective randomized double-blinded study of the effect of intravenous fluid therapy on adverse outcomes on outpatient surgery. Anesth Analg. 1995;80:682–6.PubMedGoogle Scholar
  19. 19.
    Monti S, Pokorny ME. Preop fluid bolus reduces risk of post op nausea and vomiting: A pilot study. The Internet Journal of Advanced Nursing Practice. 2000;4(2). Accessed December 2012.Google Scholar
  20. 20.
    Maharaj CH, Kallam SR, Malik A, Hassett P, Grady D, Laffey JG. Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients. Anesth Analg. 2005;100(3):675–82. Table of contents. PubMed PMID: 15728051.PubMedCrossRefGoogle Scholar
  21. 21.
    Conway B. Prevention and management of postoperative nausea and vomiting in adults. AORN J. 2009;90(3):391–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Orhan SM, Kranke P, Sessler D, Apfel CC. Does supplemental oxygen reduce postoperative nausea and vomiting? A Meta-Analysis of Randomized Control Trials. Anesth Analg. 2008;106(6):1733–8.CrossRefGoogle Scholar
  23. 23.
    Greif R, Laciny S, Rapf B, et al. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 1999;91:1246–52.PubMedCrossRefGoogle Scholar
  24. 24.
    Ochman C, Tuschy B, Beschmann R, Florian R, Kerstin D, Piper S. Supplemental oxygen reduces serotonin levels in plasma and platelets during colorectal surgery and reduces post operative nausea and vomiting. Eur J Anesthesiol. 2010;27(12):1036–43.CrossRefGoogle Scholar
  25. 25.
    Piper SN, Röhm KD, Boldt J, Faust KL, Maleck WH, Kranke P, Suttner SW. Inspired oxygen fraction of 0.8 compared with 0.4 does not further reducepostoperative nausea and vomiting in dolasetron-treated patients undergoinglaparoscopic cholecystectomy. Br J Anaesth. 2006;97(5):647–53.PubMedCrossRefGoogle Scholar
  26. 26.
    Turan A, Apfel CC, Kumpch M, Danzeisen O, Eberhart LH, Forst H, Heringhaus C, Isselhorst C, Trenkler S, Trick M, Vedder I, Kerger H. Does the efficacy of supplemental oxygen for the prevention of postoperative nausea and vomiting depend on the measured outcome, observational period or site of surgery? Anaesthesia. 2006;61(7):628–33.PubMedCrossRefGoogle Scholar
  27. 27.
    Fan CF, Tanhui T, Joshi S, Trivedi S, Hong Y, Shevde K. Acupressure treatment for prevention of post operative nausea and vomiting. Anesth Anal. 1997;84:821–5.Google Scholar
  28. 28.
    Hamon D, Ryan M, Kelly A, et al. Acupressure and prevention of nausea and vomiting after spinal anesthesia for Cesarean section. Br J Anaesth. 2000;84(4):463–7.CrossRefGoogle Scholar
  29. 29.
    Yentis SM, Bissonette B. P6 acupressure and postoperative nausea after tonsillectomy in children. Br J Anaesth. 1991;67:779–80.PubMedCrossRefGoogle Scholar
  30. 30.
    Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol. 1994;84:245–8.PubMedGoogle Scholar
  31. 31.
    Ming JL, Kuo BI, Lin JG, Lin LC. The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. J Adv Nurs. 2002;39(4):343–51.PubMedCrossRefGoogle Scholar
  32. 32.
    Windle PE, Borromeo A, Robles H, Ilacio-Uy V. The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients. J Perianesth Nurs. 2001;16(3):158–1562.PubMedCrossRefGoogle Scholar
  33. 33.
    Ho C-M, Tsai H-J, Chan K-H, Tsai S-K. P6 Acupressure does not prevent emesis during spinal anesthesia for Cesarean delivery. Anesth Analg. 2006;102(3):900–3.PubMedCrossRefGoogle Scholar
  34. 34.
    Merritt BA, Okyere CP, Jasinski DM. Isopropyl alcohol inhalation: alternative treatment of postoperative nausea and vomiting. Nurs Res. 2002;51(2):125–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Spencer KW. Isopropyl alcohol inhalation as treatment for nausea and vomiting. Plast Surg Nurs. 2004;24(4):149–54.PubMedGoogle Scholar
  36. 36.
    Anderson LA, Gross JB. Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. J Perianesth Nurs. 2004;19(1):29–31.PubMedCrossRefGoogle Scholar
  37. 37.
    Maple JT, Keswani RN, Hovis RM, Saddedin EZ, Jonnalagadda S, Azar RR, Hagen C, Thompson DM, Waldbaum L, Edmundowicz SA. Carbon dioxide insufflation during ERCP for reduction of post procedure pain: a randomized, double-blind, controlled trial. Gastrointest Endosc. 2009;70(2):278–83.PubMedCrossRefGoogle Scholar
  38. 38.
    le Roux CW, Aylwin SJ, Batterham RL, Borg CM, Coyle F, Prasad V, Shurey S, Ghatei MA, Patel AG, Bloom SR. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg. 2006;243(1):108–14.PubMedCrossRefGoogle Scholar
  39. 39.
    Crujeiras AB, Goyenechea E, Abete I, Lage M, Carriera M, Martinez A, Casanueva FF. Weight regain after a diet induced loss is predicted by higher baseline Leptin and lower Ghrelin plasma levels. J Clin Endocrinol. 2010;95(11):5037–44.CrossRefGoogle Scholar
  40. 40.
    MacLean PS, Higgins JA, Jackman MR, Johnson GC, Fleming-Elder BK, Wyatt HR, Melanson EL, Hill JO. Peripheral metabolic responses to prolonged weight reduction that promotes rapid, efficient regain in obesity-prone rats. Am J Physiol Regul Integr Comp Physiol. 2006;290(6):1577–88.CrossRefGoogle Scholar
  41. 41.
    Dulloo AG, Jacquet J, Solinas G, Montani JP, Schutz Y. Body composition phenotypes in pathways to obesity and the metabolic syndrome. Int J Obes (Lond). 2010;34(S2):S4–17.CrossRefGoogle Scholar
  42. 42.
    Poon MY, Tarrant M. Obesity: attitudes of undergraduate student nurses and registered nurses. J Clin Nurs. 2009;18(16):2355–65.PubMedCrossRefGoogle Scholar
  43. 43.
    Latner JD, O’Brien KS, Durso LE, Brinkman LA, MacDonald T. Weighing obesity stigma: the relative strength of different forms of bias. Int J Obes (Lond). 2008;32(7):1145–52.CrossRefGoogle Scholar
  44. 44.
    Coleman KJ, Toussi R, Fujioka K. Do gastric bypass patient characteristics, behavior, and health differ depending upon how successful weight loss is defined? Obes Surg. 2010;20(10):1385–92.PubMedCrossRefGoogle Scholar
  45. 45.
    Poole NA, Ashraf AA, Kuhanendran D, Bidlake L, Fiennes A, McClusky S, Nussey S, Bano G, Morgan JF. Compliance with surgical after-care following Bariatric surgery for morbid obesity: a retrospective study. Obes Surg. 2005;15:261–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Elkins G, Whitfield P, Marcus J, Symmonds R, Rodriguez J, Cook T. Noncompliance with behavioral recommendations following Bariatric surgery. Obes Surg. 2005;15(4):546–51.PubMedCrossRefGoogle Scholar
  47. 47.
    Samuel-Hodge CD, Johnston LF, Gizlice Z, Garcia BA, Lindsley SC, Bramble KP, Hardy TE, Ammerman AS, Poindexter PA, Will JC, Keyserling TC. Randomized trial of a behavioral weight loss intervention for low-income women: the Weight Wise Program. Obesity (Silver Spring). 2009;17(10):1891–9.CrossRefGoogle Scholar
  48. 48.
    Orth WS, Madan AK, Taddeucci RJ, Coday MA, Tichansky DS. Support Group meeting attendance is associated with better weight loss. Obes Surg. 2008;18(4):391–4.PubMedCrossRefGoogle Scholar
  49. 49.
    Armstrong SN, Anderson M, Le ET, Nguyen LH. Application of the Health Belief Model to Bariatric surgery. Gastroenterol Nurs. 2009;32(3):171–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Endoscopy Center, Brigham and Women’s HospitalBostonUSA

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