Open Access Review

Effective nursing care and management of bariatric surgery for obesity

by Arjunan Sundaresan 1,2
1
Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar-608 002, Tamil Nadu, India
2
Department of Biochemistry, PRIST Deemed To Be University, Thanjavur - 613403, Tamil Nadu, India
*
Author to whom correspondence should be addressed.
IJCMR  2024 2(6):41; https://doi.org/10.61466/ijcmr2060001
Received: 6 August 2024 / Accepted: 9 September 2024 / Published Online: 15 October 2024

Abstract

Obese people are susceptible to health complications and diseases, such as cardiovascular disorders, type 2 diabetes, hypertension, osteoarthritis, gallstone, hypoxia, certain cancers and even mental and intellectual and disabilities. Bariatric surgery is a prevalent weight loss approach, predominantly in situations where prior efforts towards weight reduction proved ineffective. It engages a modification in the digestive system by limiting food consumption, leading to decreased stomach capacity and physiological ability for nutrient absorption. Since obesity associates with morbidity, the pre, intra and post-operative care and post-discharge rehabilitation comprise key determining factors for a successful bariatric surgery. The process may involve short- and long-term recuperation in nursing homes and hospitals, which accord significant impact on patient’s well-being and psychology. Nursing care for these individuals with unique physiological and emotional problems is often an arduous task, requiring environmental modifications, mobility training facilities and bariatric program and care-related equipment. Special attention is required from nursing professionals towards minimum fall and injury, management of related problems, including arterial venous insufficiency, neuropathic ulcers, seromas, anastomotic leaks, abdominal wound dehiscence and post-surgery complications, together with increased hygiene and skin care. Through an interdisciplinary approach, regular monitoring of diet, nutritional parameters, including weight change, Body Mass Index, energy and protein requirement, medication, clinical complications, functional mobility, psychosocial issues, etc. can be essential. Overall, the current review enlightens the importance of bariatric surgery, and particularly offers critical assessment of nursing care systems and specialized rehabilitation services addressing physical and mental health care in obese and post-operative patients.


Copyright: © 2024 by Sundaresan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Share and Cite

ACS Style
Sundaresan, A. Effective nursing care and management of bariatric surgery for obesity. International Journal of Clinical Medical Research, 2024, 2, 41. doi:10.61466/ijcmr2060001
AMA Style
Sundaresan A. Effective nursing care and management of bariatric surgery for obesity. International Journal of Clinical Medical Research; 2024, 2(6):41. doi:10.61466/ijcmr2060001
Chicago/Turabian Style
Sundaresan, Arjunan 2024. "Effective nursing care and management of bariatric surgery for obesity" International Journal of Clinical Medical Research 2, no.6:41. doi:10.61466/ijcmr2060001

Article Metrics

Article Access Statistics

References

  1. Hruby, A. and Hu, F.B., The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics, 2015. 33(7): p. 673-89.
  2. Gurnani, M., Birken, C., and Hamilton, J., Childhood Obesity: Causes, Consequences, and Management. Pediatr Clin North Am, 2015. 62(4): p. 821-40.
  3. Stahl, J.M. and Malhotra, S., Obesity Surgery Indications And Contraindications, in StatPearls. 2022: Treasure Island (FL).
  4. Wolfe, B.M., Kvach, E., and Eckel, R.H., Treatment of Obesity: Weight Loss and Bariatric Surgery. Circ Res, 2016. 118(11): p. 1844-55.
  5. Stenberg, E., Dos Reis Falcao, L.F., O'Kane, M., et al., Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg, 2022. 46(4): p. 729-751.
  6. Grindel, M.E. and Grindel, C.G., Nursing care of the person having bariatric surgery. Medsurg Nurs, 2006. 15(3): p. 129-45; quiz 146.
  7. Karaca, A. and Durna, Z., Patient satisfaction with the quality of nursing care. Nurs Open, 2019. 6(2): p. 535-545.
  8. Wilson, J.A. and Clark, J.J., Obesity: impediment to wound healing. Crit Care Nurs Q, 2003. 26(2): p. 119-32.
  9. Benalcazar, D.A. and Cascella, M., Obesity Surgery Pre-Op Assessment And Preparation, in StatPearls. 2022: Treasure Island (FL).
  10. Albaugh, V.L. and Abumrad, N.N., Surgical treatment of obesity. F1000Res, 2018. 7.
  11. Couchman, B.A., Wetzig, S.M., Coyer, F.M., et al., Nursing care of the mechanically ventilated patient: what does the evidence say? Part one. Intensive Crit Care Nurs, 2007. 23(1): p. 4-14.
  12. Coyer, F.M., Wheeler, M.K., Wetzig, S.M., et al., Nursing care of the mechanically ventilated patient: what does the evidence say? Part two. Intensive Crit Care Nurs, 2007. 23(2): p. 71-80.
  13. Lorico, S. and Colton, B., Medication management and pharmacokinetic changes after bariatric surgery. Can Fam Physician, 2020. 66(6): p. 409-416.
  14. Darwich, A.S., Henderson, K., Burgin, A., et al., Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes. Br J Clin Pharmacol, 2012. 74(5): p. 774-87.
  15. Chopra, T., Zhao, J.J., Alangaden, G., et al., Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens. Expert Rev Pharmacoecon Outcomes Res, 2010. 10(3): p. 317-28.
  16. Boulet, L.P., Turcotte, H., Martin, J., et al., Effect of bariatric surgery on airway response and lung function in obese subjects with asthma. Respir Med, 2012. 106(5): p. 651-60.
  17. Elrazek, A.E., Elbanna, A.E., and Bilasy, S.E., Medical management of patients after bariatric surgery: Principles and guidelines. World J Gastrointest Surg, 2014. 6(11): p. 220-8.
  18. Barras, M. and Legg, A., Drug dosing in obese adults. Aust Prescr, 2017. 40(5): p. 189-193.
  19. Pai, M.P., Drug dosing based on weight and body surface area: mathematical assumptions and limitations in obese adults. Pharmacotherapy, 2012. 32(9): p. 856-68.
  20. Sherf Dagan, S., Goldenshluger, A., Globus, I., et al., Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr, 2017. 8(2): p. 382-394.
  21. Malone, M., Recommended nutritional supplements for bariatric surgery patients. Ann Pharmacother, 2008. 42(12): p. 1851-8.
  22. Grosse, C.S. and Cope, V.C., Dietary Fibre Intake and Bowel Habits After Bariatric Surgery: a Structured Literature Review. Obes Surg, 2019. 29(7): p. 2247-2254.
  23. Abbott, S., Parretti, H.M., and Greenfield, S., Experiences and perceptions of dietitians for obesity management: a general practice qualitative study. J Hum Nutr Diet, 2021. 34(3): p. 494-503.
  24. Furtado, L.C., Nutritional management after Roux-en-Y gastric bypass. Br J Nurs, 2010. 19(7): p. 428-36.
  25. Sherf-Dagan, S., Sinai, T., Goldenshluger, A., et al., Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice. Adv Nutr, 2021. 12(3): p. 1020-1031.
  26. Leahy, C.R. and Luning, A., Review of nutritional guidelines for patients undergoing bariatric surgery. AORN J, 2015. 102(2): p. 153-60.
  27. Brown, E.K., Settle, E.A., and Van Rij, A.M., Food intake patterns of gastric bypass patients. J Am Diet Assoc, 1982. 80(5): p. 437-43.
  28. Clutts, B.J., Recognition and management of complications following Roux-en-Y gastric bypass: a guide for health care workers in non-bariatric hospitals. Medsurg Nurs, 2009. 18(6): p. 335-41.
  29. Faintuch, J., Matsuda, M., Cruz, M.E., et al., Severe protein-calorie malnutrition after bariatric procedures. Obes Surg, 2004. 14(2): p. 175-81.
  30. Hsia, A.W., Hattab, E.M., and Katz, J.S., Malnutrition-induced myopathy following Roux-en-Y gastric bypass. Muscle Nerve, 2001. 24(12): p. 1692-4.
  31. Goldner, W.S., O'Dorisio, T.M., Dillon, J.S., et al., Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg, 2002. 12(5): p. 685-92.
  32. Riedt, C.S., Brolin, R.E., Sherrell, R.M., et al., True fractional calcium absorption is decreased after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring), 2006. 14(11): p. 1940-8.
  33. Goode, L.R., Brolin, R.E., Chowdhury, H.A., et al., Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res, 2004. 12(1): p. 40-7.
  34. Brolin, R.E. and Leung, M., Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg, 1999. 9(2): p. 150-4.
  35. Chaves, L.C., Faintuch, J., Kahwage, S., et al., A cluster of polyneuropathy and Wernicke-Korsakoff syndrome in a bariatric unit. Obes Surg, 2002. 12(3): p. 328-34.
  36. Kushner, R.F. and Shanta Retelny, V., Emergence of pica (ingestion of non-food substances) accompanying iron deficiency anemia after gastric bypass surgery. Obes Surg, 2005. 15(10): p. 1491-5.
  37. Rhode, B.M., Shustik, C., Christou, N.V., et al., Iron absorption and therapy after gastric bypass. Obes Surg, 1999. 9(1): p. 17-21.
  38. Updegraff, T.A. and Neufeld, N.J., Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc, 1981. 78(2): p. 135-40.
  39. Ponsky, T.A., Brody, F., and Pucci, E., Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass. J Am Coll Surg, 2005. 201(1): p. 125-31.
  40. Dixon, A.E. and Peters, U., The effect of obesity on lung function. Expert Rev Respir Med, 2018. 12(9): p. 755-767.
  41. Mahadev, S., Salome, C.M., Berend, N., et al., The effect of low lung volume on airway function in obesity. Respir Physiol Neurobiol, 2013. 188(2): p. 192-9.
  42. Hodgson, L.E., Murphy, P.B., and Hart, N., Respiratory management of the obese patient undergoing surgery. J Thorac Dis, 2015. 7(5): p. 943-52.
  43. Nastalek, P., Polok, K., Celejewska-Wojcik, N., et al., Impact of bariatric surgery on obstructive sleep apnea severity and continuous positive airway pressure therapy compliance-prospective observational study. Sci Rep, 2021. 11(1): p. 5003.
  44. Fernandez-Bustamante, A., Hashimoto, S., Serpa Neto, A., et al., Perioperative lung protective ventilation in obese patients. BMC Anesthesiol, 2015. 15: p. 56.
  45. Masa, J.F., Pepin, J.L., Borel, J.C., et al., Obesity hypoventilation syndrome. Eur Respir Rev, 2019. 28(151).
  46. Iftikhar, I.H. and Roland, J., Obesity Hypoventilation Syndrome. Clin Chest Med, 2018. 39(2): p. 427-436.
  47. Mokhlesi, B., Obesity hypoventilation syndrome: a state-of-the-art review. Respir Care, 2010. 55(10): p. 1347-62; discussion 1363-5.
  48. Raphelson, J.R., Schmickl, C.N., Sonners, C., et al., Obesity Hypoventilation Syndrome and Postsurgical Outcomes in a Bariatric Surgery Cohort. Obes Surg, 2022. 32(7): p. 1-7.
  49. Carron, M., Zarantonello, F., Ieppariello, G., et al., Obesity and perioperative noninvasive ventilation in bariatric surgery. Minerva Chir, 2017. 72(3): p. 248-264.
  50. Powell-Wiley, T.M., Poirier, P., Burke, L.E., et al., Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation, 2021. 143(21): p. e984-e1010.
  51. Poirier, P., Giles, T.D., Bray, G.A., et al., Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol, 2006. 26(5): p. 968-76.
  52. De Troyer, A., Borenstein, S., and Cordier, R., Analysis of lung volume restriction in patients with respiratory muscle weakness. Thorax, 1980. 35(8): p. 603-10.
  53. Parameswaran, K., Todd, D.C., and Soth, M., Altered respiratory physiology in obesity. Can Respir J, 2006. 13(4): p. 203-10.
  54. Sood, A., Altered resting and exercise respiratory physiology in obesity. Clin Chest Med, 2009. 30(3): p. 445-54, vii.
  55. Moreira, R.A., Caetano, J.A., Barros, L.M., et al., [Nursing diagnoses, related factors and risk factors during the postoperative period following bariatric surgery]. Rev Esc Enferm USP, 2013. 47(1): p. 168-75.
  56. van Genderen, M.E., Paauwe, J., de Jonge, J., et al., Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults. Crit Care, 2014. 18(3): p. R114.
  57. Alpert, M.A., Omran, J., and Bostick, B.P., Effects of Obesity on Cardiovascular Hemodynamics, Cardiac Morphology, and Ventricular Function. Curr Obes Rep, 2016. 5(4): p. 424-434.
  58. Algahim, M.F., Lux, T.R., Leichman, J.G., et al., Progressive regression of left ventricular hypertrophy two years after bariatric surgery. Am J Med, 2010. 123(6): p. 549-55.
  59. Kuno, T., Tanimoto, E., Morita, S., et al., Effects of Bariatric Surgery on Cardiovascular Disease: A Concise Update of Recent Advances. Front Cardiovasc Med, 2019. 6: p. 94.
  60. Cummings, D.E. and Cohen, R.V., Bariatric/Metabolic Surgery to Treat Type 2 Diabetes in Patients With a BMI <35 kg/m2. Diabetes Care, 2016. 39(6): p. 924-33.
  61. Ngiam, K.Y., Lee, W.J., Lee, Y.C., et al., Efficacy of metabolic surgery on HbA1c decrease in type 2 diabetes mellitus patients with BMI <35 kg/m2--a review. Obes Surg, 2014. 24(1): p. 148-58.
  62. Fried, M., Ribaric, G., Buchwald, J.N., et al., Metabolic surgery for the treatment of type 2 diabetes in patients with BMI <35 kg/m2: an integrative review of early studies. Obes Surg, 2010. 20(6): p. 776-90.
  63. Peterson, K., Anderson, J., Boundy, E., et al., Rapid Evidence Review of Bariatric Surgery in Super Obesity (BMI >/= 50 kg/m(2)). J Gen Intern Med, 2017. 32(Suppl 1): p. 56-64.
  64. Shah, A.S., D'Alessio, D., Ford-Adams, M.E., et al., Bariatric Surgery: A Potential Treatment for Type 2 Diabetes in Youth. Diabetes Care, 2016. 39(6): p. 934-40.
  65. Whitmore, C., Type 2 diabetes and obesity in adults. Br J Nurs, 2010. 19(14): p. 880, 882-6.
  66. Niemi, S., Maentausta, O., Bolton, N.J., et al., Time-resolved immunofluorometric assay of human SHBG. Steroids, 1988. 52(4): p. 413-4.
  67. Chu, A.S., Mataga, M.A., Krueger, L., et al., Nutrient Deficiency-Related Dermatoses after Bariatric Surgery. Adv Skin Wound Care, 2019. 32(10): p. 443-455.
  68. Sampathraju, S. and Rodrigues, G., Seroma formation after mastectomy: pathogenesis and prevention. Indian J Surg Oncol, 2010. 1(4): p. 328-33.
  69. Nelson, J.A., Sobti, N., Patel, A., et al., The Impact of Obesity on Patient-Reported Outcomes Following Autologous Breast Reconstruction. Ann Surg Oncol, 2020. 27(6): p. 1877-1888.
  70. Toninello, P., Montanari, A., Bassetto, F., et al., Nutritional Support for Bariatric Surgery Patients: The Skin beyond the Fat. Nutrients, 2021. 13(5).
  71. Lee, K.T., Lee, H., Jeon, B.J., et al., Impact of overweight/obesity on the development of hematoma following tissue expander-based breast reconstruction. J Plast Reconstr Aesthet Surg, 2020.
  72. Newman, A., Keeley, V., Pinnington, L., et al., Prevalence and Impact of Chronic Edema in Bariatric Patients: A LIMPRINT Study. Lymphat Res Biol, 2021. 19(5): p. 431-441.
  73. Pereira de Godoy, J.M., Pereira de Godoy, L.M., Pereira de Godoy, A.C., et al., Bariatric surgery and the evaluation of subclinical systemic lymphedema. J Surg Case Rep, 2019. 2019(2): p. rjz028.
  74. Tomich, G.M., Franca, D.C., Diniz, M.T., et al., [Effects of breathing exercises on breathing pattern and thoracoabdominal motion after gastroplasty]. J Bras Pneumol, 2010. 36(2): p. 197-204.
  75. Kramer, K.L., WOC nurses as advocates for patients who are morbidly obese: a case study promoting the use of bariatric beds. J Wound Ostomy Continence Nurs, 2004. 31(6): p. 379-84; discussion 384-7.
  76. Blackett, A., Gallagher, S., Dugan, S., et al., Caring for persons with bariatric health care issues: a primer for the WOC nurse. J Wound Ostomy Continence Nurs, 2011. 38(2): p. 133-8; quiz 139-40.
  77. Wilson, J.A. and Clark, J.J., Obesity: impediment to postsurgical wound healing. Adv Skin Wound Care, 2004. 17(8): p. 426-35.
  78. Fruh, S.M., Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract, 2017. 29(S1): p. S3-S14.
  79. Lovich-Sapola, J., Smith, C.E., and Brandt, C.P., Postoperative pain control. Surg Clin North Am, 2015. 95(2): p. 301-18.
  80. Luckey, A., Livingston, E., and Tache, Y., Mechanisms and treatment of postoperative ileus. Arch Surg, 2003. 138(2): p. 206-14.
  81. Cassin, S., Leung, S., Hawa, R., et al., Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy. Nutrients, 2020. 12(10).