Dawn Mangine

    With such a significant percentage of the U.S. population being obese, and with its impact on health, healthcare providers are going to need to be prepared to provide care for overweight and obese patients.

    Treating bariatric patients can be challenging. Patients with obesity may delay seeing a healthcare provider for routine medical care. Here’s why:

    • Patients with obesity may be ashamed or embarrassed about their weight.
    • Providers and staff may say hurtful things about a patient’s weight; sometimes unintentionally, and sometimes by talking where they think a patient can’t hear them.
    • If a bariatric patient has been treated with a lack of respect in the past, they will be reluctant to risk being treated badly again, even if they decide to switch providers.

    4 Nursing Care Plans

    Nursing care management plans for patients with obesity includes identification of inappropriate behaviors that cause obesity, preparing a diet plan, determining nutritional knowledge, and providing information to patients. Treating patients with obesity requires empathy, as well as preparation, to meet the physical and emotional needs of these patients. Nursing educators can design scenarios around the following care plans.

    Imbalanced Nutrition

    Imbalanced nutrition refers to “more than body requirements,” or simply the intake of nutrients that exceeds metabolic needs. Patients with obesity eat more than they need to due to a variety of factors including psychosocial factors, socioeconomic status, sedentary lifestyles, and so on.

    The desired outcomes for this nursing care plan include:

    • The healthcare professional helps the patient identify inappropriate behaviors and consequences associated with overeating and weight gain
    • The patient demonstrates a change in eating patterns and involvement in an individual exercise program
    • The patient losses weight in a medically appropriate way and maintains health

    Disturbed Body Image

    Disturbed body image is confusion in the mental picture of one’s physical self. This confusion can be caused by biophysical or psychosocial factors such as the patient’s view of self; a family or culture encouragement of overeating; issues surrounding control, sex, or relationships.

    Desired outcomes for disturbed body image patient education include:

    • The patient will verbalize a more realistic self-image
    • The patient will demonstrate acceptance of self, instead of seeking an idealized and sometimes unattainable image
    • The healthcare professional will help the patient seek information and pursue appropriate weight loss
    • The patient will acknowledge his/her responsibility because the patient recognizes selfhood

    Impaired Social Interaction

    Impaired social interaction relates to the quantity and quality of social exchange. Patients may be uncomfortable in social situations, so they don’t participate in gatherings, or they are overly self-conscious.

    Desired outcomes to improve social interactions include:

    • The patient being able to verbalize awareness of emotions that lead to poor social interactions
    • The patient becomes involved in achieving positive changes in social behaviors and interpersonal relationships

    Deficient Knowledge

    Deficient knowledge means the absence of information related to the topic, or deficient cognitive function making the topic difficult to understand. Patients may not have access to the correct information, may lack interest in learning, or may be misinterpreting the information or have trouble recalling it when they need to. Healthcare professionals may be presenting outdated or incomplete information.

    The desired outcomes to overcome deficient knowledge include:

    • The patient is able to verbalize his or her understanding of the need for lifestyle changes to control weight
    • The patient and the healthcare professional establish individual goals and a plan for attaining those goals
    • The patient begins to seek out information about nutrition and ways to control weight, and the healthcare professional follows up with the patient

    If you are interested in purchasing a SimObesity Suit for your nursing simulation scenarios, see the suit at our website.

     

    Sources:

    “Medical Care for Patients with Obesity,” U.S. Department of Health and Human Services, NIH Publication No. 03-5335

    Get ideas for in-depth scenarios here.

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