Concept Map Illustrating Altered Human Need

Disease Name Clinical Manifestations (list expected

manifestations in textbook and circle those
Bariatric Surgery exhibited by your patient – consider
admission assessments as well. Draw links to
underlying pathophysiology)
Pathophysiology (from textbook – also try
to link your client’s underlying etiology)
POST SURGICAL COMPLICATIONS

Surgery on the stomach and/or intestines to help a person with Pernicious anemia
extreme obesity lose weight. Today, this has become a very popular dumping syndrome
option for treating obesity. Bariatric surgery is currently the only SOB/shallow breathing
treatment that has been successful in treating people who are decrease in O2 saturation
extremely obese. pain
vomiting
Guidelines for bariatric surgery are: having a BMI > 35 with other hypoxemia
significant co-morbidities such as hypertension, Diabetes type II, pulmonary hypertension
heart failure, or sleep apnea. polycythemia
venous thromboembolism
Bariatric surgery falls into three broad categories: delayed wound healing/surgical site infection
Restrictive- Includes adjustable gastric banding, gastric sleeve, iron, cobalamin, & other vitamin/mineral deficiencies
gastric plication, & gastric balloon. In these types of surgery the leak or perforation of anastomosis
stomach size is reduced, causing the person to feel full more bowel obstrcution
quickly. Digestion is not altered, so the risk for anemia or
cobalamin deficiency is low.
Malabsorption-This is known as the Biliopancreatic Diversion with
or without a Duodenal Switch. During this surgery an anastomosis Related Lab/Diagnostic Study Results
is made between the stomach & the intestine. (Draw links to connect pathophysiology
Combination of Restrictive & Malabsorptive- This is the most common and/or medication effect)
type of bariatric surgery in the U.S. It has low complication rates,
excellent patient tolerance, & sustained long-term weight loss. The
RYGB involves creating a small gastric pouch & attaching it directly to CBC
the small intestine using a Y-shaped limb of small bowel. CMP
PT/PTT/INR
Although mortality is very low, several complications can arise Iron
from surgery. Therefore, having bariatric surgery should be cobalamin/ B12
carefully considered. A1C
Lipid panel

Medications (identify classification)

(Draw links to connect indication for use
and client assessment findings)

There is no specific medication to treat bariatric surgery. Medication

that would be used to treat co-morbidities and signs & symptoms
during the post-op period.
Other Collaborative Treatments (Nutritional
Heparin (prophylaxis treatment for DVT) Therapy/Surgical Intervention/etc.)
Oxycodone/ Acetaminophen (pain)
Beta Blockers (decrease heart rate & BP)
Antihypertensives (decreased BP) Nutritionist
"Statins" (decreased hyperlipidemia) Dietitian
Insulin (to control diabetes) Psychologist/ Psychiatrist
Endocrinologist

Priority Nursing Diagnoses

Risk for Obesity

Disturbed Body Image
Risk for altered Nutrition
Risk for electrolyte imbalance
Depression