Question

Tuesday PN 200 Fundamentals of Nursing II Concept Map: Obesity Betty Lopez is a 57-year-old Hispanic woman of Puerto Rican heritage who states that she maintained her ideal weight, which she believes is about 11 pounds, until she was divorced 15 years ago, and I was very trim at that time. She has been continually gaining weight, mostly through "comfort eating" after her divorce. She also admits to nibbling on snacks at work - mostly high calorie food like brownies and Twinkies. She has previously tried OTC diet pills, multiple fad diets, meal replacement diets. "water pills' and most recently a combination of herbal products. A'I loose a bunch of weighs over one or two months and then I gain it all back and then some". She is tearful as she talks about her weight struggles. "I realize that my weight is affecting my health and I finally get some help to lose some and then keep it off for good. Past Medical History: HTN X 8 years Hypothyroidism X 5 years Bilateral osteoarthritis of knees and lower back Depression X 4 years Social History She has been a data entry clerk for the past 11 years and has been limited to sedentary work! because of her weight She feels insecure at work because she “is the only employee working there without a college degree and always has to prove herself" Enjoys walking for exercise but is now limited by her knee and back pain, limited mobility and breathlessness Height 5' 10" Weight 290 pounds 1/20

Answer 1

Nursing care plan for obesity :-

1. Nursing diagnosis - 1. Imbalanced Nutrition more than body requirements related to the increase in the intake of nutrients.

#. Interventions:

Create a meal plan with the patient.

Measure body weight per day.

Emphasize the importance of realizing full and stop inputs.

Give liquid diet, softer, high in protein and fiber and low in fat with the addition of liquid as needed.

Refer to a dietitian

Encourage clients to do a lot of activities.

#. Rationale:

After the act of division, decreased gastric capacity of approximately 50 ml, so the need to eat a little.

Supervision loss and nutritional needs.

Overeating may cause nausea / vomiting.

Provide nutrients without adding calories.

Need help planning a diet that meets the nutritional needs.

Do a lot of activities can burn more calories.

#. Positive outcome :-

- Better understanding of healthy nutrition

#. Negative outcome :-

- None

#. Evaluation - on evaluating the patient after implementation of interventions , the patient had good knowledge about healthy nutrition balance .

2 . Nursing diagnosis :- Ineffective breathing pattern related to a decrease in lung expansion.

Goal: breathing pattern becomes effective.

Expected outcomes:

Maintain adequate ventilation.

Not experiencing cyanosis or other signs of hypoxia.

Interventions:

Monitor the speed / depth of breath. auscultation of breath sounds.

Investigate cyanosis, increased restlessness.

Elevate the head of the bed 30 degrees.

Encourage deep breathing exercises.

Change position periodically and ambulation as early as possible.

Give supplemental oxygen.

help the patient use breathing apparatus.

Monitor pulse oximetry when indicated.

Rationale:

Respiratory snore decrease ventilation, can cause hypoxia.

Encourage the development of the diaphragm or lung expansion and minimize the maximum pressure in the abdominal contents.

Increase the maximum lung expansion and airway clearance.

Increase air filling the entire segment of the lung, mobilize and remove secretions.

Maximizing preparations for the exchange of oxygen and decreased breath work. Increase lung expansion, lowering atelectasis.

Show ventilation / oxygenation and acid-base status, used as a basis for evaluating the need for respiratory therapy.

#. Positive outcome - expansion of lungs

#. Negative outcome - none

#. Evaluation - patient was able to breath easily , he had normal respiratory parameters .