Bariatric Diet Plan

Bariatric Diet Teaching Plan Student Name Jacksonville University Month Day, Year

Bariatric Diet Plan Teaching Plan: Bariatric Surgery Diet Assessment of Learner: The learner is a 36-year-old female, who works as an administrative assistant for a local clothing manufacturer. She is post-op day one of an open gastric bypass surgery. Her expected hospital stay is 3-5 days. The patient has been instructed that diet compliance is the key to her success. She will have a scheduled follow up appointment for 10

days after discharge. While at home, the patient will continue with the Bariatric diet. The patient reads and understands English. Learners prior level of knowledge: The learner stated that she was taught about the Bariatric Diet Plan before her surgery, but really doesnt remember much. The learner learns best through verbal instruction and demonstration. This is the learners first major surgery. She has tried all the major diet plans before her surgery to lose weight, but without success. She understands the importance of the post-op diet, but remembers very little about the diet. Learners perception of the need to learn: The learner fully understands the importance of the post-op diet and verbally agrees to comply with the post-surgical diet while at home. The learner is interested and ready to learn. Her pain has been managed through intravenous narcotics. She requests information appropriately about the Bariatric Diet. The learner knows that without diet compliance, surgical complications are likely to arise. Learners attitude towards learning: The learner is enthusiastic about learning. The surgeon performing the bypass has been in to see the patient and explain how the surgery went. He stressed the importance of starting a diet plan on post-op day one, and following the guidelines as instructed. The learner verbally complied. The learner presents with an enthusiastic approach to learn the material at hand. Her breakfast is on the beside table, untouched.

Bariatric Diet Plan

Social, cultural, and physical factors that may affect learning: The learner has just undergone a gastric bypass surgery. She feels weak and her pain ranges from mild to moderate without exertion. She talks about wanting to know the diet so that she can loose weight. She mentions that she is sick of people making comments about her weight, at times feeling like she is on display. In this case, societies negativism is one major motivating factor. Nursing Diagnosis: Knowledge deficit related to complexity of diet plan for surgical procedure. Outcomes: Long-Term Goal: The learner will stay compliant with the Bariatric diet, loosing 60-80 pounds the first year. Intermediate Goal: The learner will loose 15 pounds by her follow-up appointment and stay compliant with the Bariatric diet. Short-Term Goal: The learner will verbalize an understanding of the Bariatric Diet stages one, two, and three before time of discharge. Materials/Resources needed: Location: Hospital room. The learner will be sitting in her chair, television will be off, light will be on, door closed. Materials: Measuring/medicine cups, Jell-O, milk, mashed potatoes, and educational handouts will be utilized during the teaching session. Number and length of teaching sessions: There will be two teaching sessions lasting 15 minutes.

Bariatric Diet Plan Behavioral Objectives Upon completion of the teaching session the learner will: Content Outline Teaching Methods

1. Define the Bariatric Diet.

I. Bariatric Diet Modified clear liquid diet with slow diet advancements Sugar and caffeine free Non-carbonated Vitamins, high-protein supplements and shakes Avoid sweetened beverages, alcohol, foods high in fat (Blackwood, 2004) Small meals Drink liquids between meals Risks: a. dumping syndrome b. nausea/vomiting c. dehydration d. blocked opening in stomach pouch e. constipation (Mayo Clinic, 2009) Behavior modification a. wait five minutes between each bite b. only three meals per day c. avoid snacking d. exercise regularly e. sip fluid f. avoid using straws (University Health Care Center, 2010)

i. Explain the Bariatric Diet. Give printed material about the three stages of the Bariatric Diet.

Bariatric Diet Plan 2. Describe the Bariatric Stage I diet. II. Bariatric Stage I Diet Clear liquids <60 ml per hour sugar substitute Jell-O Broth Sugar free popsicles Sugar free apple or cranberry juice Avoid: a. Sugar b. Regular Jell-O c. Regular coffee d. Whole or 2% milk (M. Graystorf, personal communication, March 26, 2010) ii. Lecture about the Bariatric Stage I Diet. Provide examples of acceptable clear liquids. Repetition.

3. Explain the Bariatric Stage II diet.

III. Bariatric Stage II Diet iii. Provide pamphlet about Full liquid diet the Bariatric Stage II diet. Sugar substitute One-to-one discussion Diet custard about the Bariatric Diet. Diet pudding Demonstrate what foods Cream soup are appropriate with a Juice Stage II diet. Repetition. Skim milk Decaf coffee Hot tea Avoid: a. sugar b. regular Jell-O and pudding c. regular coffee and tea d. whole and 2% milk (M. Graystorf, personal communication, March 26, 2010) IV. Bariatric Stage III Diet puree diet sugar substitute small portions tomato soup applesauce Carnation Instant iv. Explanation of the Bariatric Stage III Diet. Use visual aid of appropriate stage III food. Repetition.

4. Discuss the Bariatric Stage III diet.

Bariatric Diet Plan Breakfast with skim milk Avoid a. sugar b. regular JellO/pudding c. regular coffee/tea d. whole/2%milk (M. Graystorf, personal communication, March 26, 2010) 5. Measure 60 ml of fluid. V. Demonstrate pouring 60 ml of fluid into measuring cup. Mark several cups at the 60 ml line. v. Demonstration of measuring appropriate amount of fluid for Bariatric Stage I Diet. Provide extra supplies for learner to practice. vi. Provide printed materials with available phone numbers and diet plan.

6. Outline alternative resources for help when the learner is discharged. 7. State the time, date, and location of her followup appointment.

VI. Hand learner copy of prescribed diet and phone number to physicians office. VII. Provide follow-up information to learner; when and where with phone number. VIII. Allow patient time to ask questions.

vii. Provide written instructions.

8. Discuss questions or concerns the learner may have.

viii. One-on-one discussion.

Evaluation: The learner will: 1. Return demonstration of measurement of liquids. 2. State the progression of the Bariatric Diet Stages. 3. Recall the time, date, and location of the follow-up appointment.

Bariatric Diet Plan References

Blackwood, H. S. (2004). Obesity: A rapidly expanding challenge. Nursing Management. 35(5), 27-36. Fares II, L., Reeder, R., Bock, J., Batezel, V. (2008). 23-Hour Stay Outcomes for Laparoscopic Roux-en-Y Gastric Bypass in a Small, Teaching Community Hospital. American Surgeon, 74(12), 1206-1210. Gallagher, S. (2004). Taking the weight off with bariatric surgery. Nursing 2004, March, 59-63. Mayo Clinic Staff. (October 9, 2009). Gastric bypass diet. Retrieved from http://www.mayoclinic.com/health/gastric-bypass-diet/MY00827 University Health Care Center. ( February, 2010). Post operative diet from gastric bypass. Retrieved from http://www.upstate.edu/uhpated/pdf/gastricbypass_diet.pdf