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CARE SETTING
RELATED CONCERNS
Hypertension: severe
Myocardial infarction
ACTIVITY/REST
May exhibit:
Increased heart
rate/respirations with
activity
CIRCULATION
May exhibit:
Hypertension, edema
EGO INTEGRITY
Eating relieves
unpleasant feelings,
e.g., loneliness,
frustration, boredom
Perception of body
image as undesirable
FOOD/FLUID
May report:
Normal/excessive
ingestion of food
Experimentation with
numerous types of
diets ("yo-yo" dieting)
with varied/short-lived
results
History of recurrent
weight loss and gain
PAIN/DISCOMFORT
May report:
Pain/discomfort on
weight-bearing joints or
spine
RESPIRATION
May exhibit:
Cyanosis, respiratory
distress (Pickwickian
syndrome)
SEXUALITY
TEACHING/LEARNING
May report: Problem
may be lifelong or
related to life event
Family history of
obesity
Concomitant health
problems may include
hypertension, diabetes,
gallbladder and
cardiovascular disease,
hypothyroidism
considerations: May
require support with
therapeutic regimen;
home modifications,
assistive
devices/equipment.
DIAGNOSTIC STUDIES
NURSING PRIORITIES
1. Assist patient to identify a workable method of weight control
incorporating healthful foods.
DISCHARGE GOALS
May be related to
Psychosocial factors
Socioeconomic status
Possibly evidenced by
ACTIONS/INTERVENTIONS RATIONALE
Independent
Identifies/influences choice of
Review individual cause for some interventions.
obesity, e.g., organic or
nonorganic.
ACTIONS/INTERVENTIONS RATIONALE
Independent
Exercise furthers weight loss by
Determine current activity levels reducing appetite; increasing
and plan progressive exercise energy; toning muscles; and
program (e.g., walking) tailored to enhancing cardiac fitness, sense of
the individual’s goals and choice. well-being, and accomplishment.
Commitment on the part of the
patient enables the setting of more
realistic goals and adherence to
the plan.
Collaborative
ACTIONS/INTERVENTIONS RATIONALE
Collaborative
Lipase inhibitor blocks absorption
Orlistat (Xenical); of approximately 30% of dietary
fat. Facilitates weight
loss/maintenance when used in
conjuction with a reduced-calorie
diet. Also reduces risk of regain
after weight loss.
May be related to
Possibly evidenced by
Self-Esteem (NOC)
ACTIONS/INTERVENTIONS RATIONALE
Independent
Mental image includes our ideal
Determine patient’s view of being and is usually not up-to-date. Fat
fat and what is does for the and compulsive eating behaviors
individual. may have deep-rooted
psychological implications, (e.g.,
compensation for lack of love and
nurturing or a defense against
intimacy).
ACTIONS/INTERVENTIONS RATIONALE
Independent
The individual may harbor
Identify patient’s motivation for repressed feeling of hostility,
weight loss and assist with goal which may be expressed inward on
setting. the self. Because of a poor self-
concept the person often has
difficulty with relationships. Note:
When losing weight for someone
else, the patient is less likely to be
successful/maintain weight loss.
May be related to
Self-concept disturbance
Possibly evidenced by
ACTIONS/INTERVENTIONS RATIONALE
Socialization Enhancement
(NIC)
Independent
Social interaction is primarily
Review family patterns of relating learned within the family of origin.
and social behaviors. When inadequate patterns are
identified, actions for change can
be instituted.
Collaborative
May be related to
Possibly evidenced by
ACTIONS/INTERVENTIONS RATIONALE
Independent
Necessary to know what additional
Determine level of nutritional information to provide. When
knowledge and what patient patient’s views are listened to,
believes is most urgent need. trust is enhanced.