Nursing and Interprofessional management: Obesity

Nursing and Interprofessional management: Obesity

• Nursing Assessment
  • Subjective Data
    • Important Health information
      • First rule out physical conditions that may be causing or contributing to obesity
        • Be sensitive and nonjudgmental
        • Clarify rationale for inquiries about weight, dietary habits, and exercise
        • Address patient concerns
    • Past health history
      • Time of obesity onset
      • Diseases related to metabolism and obesity
        • • Hypertension
          • Cardiovascular problems
          • Stroke
          • Cancer
          • Chronic joint pain
          • Respiratory problems
          • Diabetes mellitus
          • Cholelithiasis
          • Metabolic syndrome
    • Medications
      • Thyroid preparations
      • Diet pills
      • Herbal products
    • Surgery or other treatments
      • Prior weight-reduction procedures (bariatric surgery)

• • Functional Health patterns
    • Health perception–health management: Family history of obesity; perception of problem; methods of weight loss attempted
    • Nutritional-metabolic: Amount and frequency of eating; overeating in response to boredom, stress, specific times, or activities; history of weight gain and loss
    • Elimination: Constipation
    • Activity-exercise: Typical physical activity; drowsiness, somnolence; dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea
    • Sleep-rest: Sleep apnea, use of continuous positive airway pressure
    • (CPAP)
    • Cognitive-perceptual: Feelings of rejection, depression, isolation, guilt, or shame; meaning or value of food; adherence to prescribed reducing diets, degree of long-term commitment to a weight loss program
    • Role-relationship: Change in financial status or family relationships; personal, social, and financial resources to support a reducing diet
    • Sexuality-reproductive: Menstrual irregularity, heavy menstrual low in women, birth control practices, infertility; effect of obesity on sexual activity and attractiveness to significant other
  • Objective Data
    • General
      • Body mass index ≥30 kg/m2; waist circumference: woman >35 in (89 cm), man >40 in (102 cm)
    • Respiratory
      • Increased work of breathing; wheezing; rapid, shallow breathing
    • Cardiovascular
      • Hypertension, tachycardia, dysrhythmias
    • Musculoskeletal
      • Decreased joint mobility and flexibility; knee, hip, and low back pain
    • Reproductive
      • Gynecomastia and hypogonadism in men
    • Possible Diagnostic Findings
      • Elevated serum glucose, cholesterol, triglycerides; chest x-ray demonstrating enlarged heart; electrocardiogram showing dysrhythmia; abnormal liver function tests