Obesity is defined as an excess accumulation of body fat at least 20% over average desired weight for age, sex, and height or a body mass index (kg/m2) of greater than 27.8 for men and greater than 27.3 for women. Obesity is a chronic condition considered by some to be a disability. The general prognosis for achieving and maintaining weight loss is poor; however, the desire for a healthier lifestyle and reduction of risk factors associated with life-threatening illnesses motivate many people toward diets and weight-loss programs.
CARE SETTING
Community level unless morbid obesity requires brief inpatient stay
RELATED CONCERNS
Cerebrovascular accident (CVA)/stroke
Cholecystitis with cholelithiasis
Cirrhosis of the liver
Diabetes mellitus/Diabetic ketoacidosis
Heart failure: chronic
Hypertension: severe
Myocardial infarction
Obesity: surgical interventions (gastric partitioning/gastroplasty, gastric bypass)
Psychosocial aspects of care
Thrombophlebitis: deep vein thrombosis
Patient Assessment Database
ACTIVITY/REST
May report: Fatigue, constant drowsiness
Inability/lack of desire to be active or engage in regular exercise; sedentary lifestyle
Dyspnea with exertion
May exhibit: Increased heart rate/respirations with activity
CIRCULATION
May exhibit: Hypertension, edema
EGO INTEGRITY
May report: History of cultural/lifestyle factors affecting food choices
Weight may/may not be perceived as a problem
Eating relieves unpleasant feelings, e.g., loneliness, frustration, boredom
Perception of body image as undesirable
SOs resistant to weight loss (may sabotage patient’s efforts)
FOOD/FLUID
May report: Normal/excessive ingestion of food
Experimentation with numerous types of diets (“yo-yo” dieting) with varied/short-lived results
History of recurrent weight loss and gain
May exhibit: Weight disproportionate to height
Endomorphic body type (soft/round)
Failure to adjust food intake to diminishing requirements (e.g., change in lifestyle from active to sedentary, aging)
PAIN/DISCOMFORT
May report: Pain/discomfort on weight-bearing joints or spine
RESPIRATION
May report: Dyspnea
May exhibit: Cyanosis, respiratory distress (Pickwickian syndrome)
SEXUALITY
May report: Menstrual disturbances, amenorrhea
TEACHING/LEARNING
May report: Problem may be lifelong or related to life event
Family history of obesity
Concomitant health problems may include hypertension, diabetes, gallbladder and cardiovascular disease, hypothyroidism
Discharge plan
DRG projected mean length of inpatient stay: 5.1 days
May require support with therapeutic regimen; home modifications, assistive
devices/equipment.
Refer to section at end of plan for postdischarge considerations.
DIAGNOSTIC STUDIES
Metabolic/endocrine studies: May reveal abnormalities, e.g., hypothyroidism, hypopituitarism, hypogonadism, Cushing’s syndrome (increased insulin levels), hyperglycemia, hyperlipidemia, hyperuricemia, hyperbilirubinemia. It is also suggested that the cause of these disorders may arise from neuroendocrine abnormalities within the hypothalamus, which result in various chemical disturbances.
Anthropometric measurements: Measures fat-to-muscle ratio.
NURSING PRIORITIES
1. Assist patient to identify a workable method of weight control incorporating healthful foods.
2. Promote improved self-concept, including body image, self esteem.
3. Encourage health practices to provide for weight control throughout life.
DISCHARGE GOALS
1. Healthy patterns for eating and weight control identified.
2. Weight loss toward desired goal established.
3. Positive perception of self verbalized.
4. Plans developed for future weight control.
5. Plan in place to meet needs after discharge.
CARE SETTING
Community level unless morbid obesity requires brief inpatient stay
RELATED CONCERNS
Cerebrovascular accident (CVA)/stroke
Cholecystitis with cholelithiasis
Cirrhosis of the liver
Diabetes mellitus/Diabetic ketoacidosis
Heart failure: chronic
Hypertension: severe
Myocardial infarction
Obesity: surgical interventions (gastric partitioning/gastroplasty, gastric bypass)
Psychosocial aspects of care
Thrombophlebitis: deep vein thrombosis
Patient Assessment Database
ACTIVITY/REST
May report: Fatigue, constant drowsiness
Inability/lack of desire to be active or engage in regular exercise; sedentary lifestyle
Dyspnea with exertion
May exhibit: Increased heart rate/respirations with activity
CIRCULATION
May exhibit: Hypertension, edema
EGO INTEGRITY
May report: History of cultural/lifestyle factors affecting food choices
Weight may/may not be perceived as a problem
Eating relieves unpleasant feelings, e.g., loneliness, frustration, boredom
Perception of body image as undesirable
SOs resistant to weight loss (may sabotage patient’s efforts)
FOOD/FLUID
May report: Normal/excessive ingestion of food
Experimentation with numerous types of diets (“yo-yo” dieting) with varied/short-lived results
History of recurrent weight loss and gain
May exhibit: Weight disproportionate to height
Endomorphic body type (soft/round)
Failure to adjust food intake to diminishing requirements (e.g., change in lifestyle from active to sedentary, aging)
PAIN/DISCOMFORT
May report: Pain/discomfort on weight-bearing joints or spine
RESPIRATION
May report: Dyspnea
May exhibit: Cyanosis, respiratory distress (Pickwickian syndrome)
SEXUALITY
May report: Menstrual disturbances, amenorrhea
TEACHING/LEARNING
May report: Problem may be lifelong or related to life event
Family history of obesity
Concomitant health problems may include hypertension, diabetes, gallbladder and cardiovascular disease, hypothyroidism
Discharge plan
DRG projected mean length of inpatient stay: 5.1 days
May require support with therapeutic regimen; home modifications, assistive
devices/equipment.
Refer to section at end of plan for postdischarge considerations.
DIAGNOSTIC STUDIES
Metabolic/endocrine studies: May reveal abnormalities, e.g., hypothyroidism, hypopituitarism, hypogonadism, Cushing’s syndrome (increased insulin levels), hyperglycemia, hyperlipidemia, hyperuricemia, hyperbilirubinemia. It is also suggested that the cause of these disorders may arise from neuroendocrine abnormalities within the hypothalamus, which result in various chemical disturbances.
Anthropometric measurements: Measures fat-to-muscle ratio.
NURSING PRIORITIES
1. Assist patient to identify a workable method of weight control incorporating healthful foods.
2. Promote improved self-concept, including body image, self esteem.
3. Encourage health practices to provide for weight control throughout life.
DISCHARGE GOALS
1. Healthy patterns for eating and weight control identified.
2. Weight loss toward desired goal established.
3. Positive perception of self verbalized.
4. Plans developed for future weight control.
5. Plan in place to meet needs after discharge.
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