Mobility is a basic human need that, when not met, leads to a cascade of physical problems. Meeting the challenge of safe mobility for bariatric patients is a concern for many healthcare institutions. More than 20% of the adult population now has a body mass index equal to or greater than 30 and are classified as obese. Obesity is associated with many well-known health risks, including heart disease, metabolic disorders, and cancer. Nurses should be aware of these health risks, the interplay between mobility and health risks, and the national guidelines for treating the obese patient population. This article presents an overview of national guidelines for identifying, evaluating, and treating bariatric patients and identifies issues that create challenges to providing a safe environment for mobility among hospitalized obese patients.
Pseudo-obstruction is actually a group of disorders resulting in bowel dysmotility in the absence of anatomic obstruction. Because of varied pathologic abnormalities of the GI tract involved in the disorder, pseudo-obstruction has been reported in the literature under different names, including hypoganglionosis, chronic adynamic ileus, pseudo-Hirschprung's disease, visceral neuropathy, visceral myopathy, and megacystis-microcolon-intestinal hypoperistalsis syndrome. Although a rare condition, its effects are severe, disabling, and life-threatening in pediatric clients. Prognosis is inversely correlated with age and is especially poor in those children with symptoms as newborns. Management involves promoting nutrition adequate for growth, treating symptoms, and preventing complications. Total parenteral nutrition is almost always required, and its long-term use is associated with chronic cholestasis and potential hepatic failure. Nurses may encounter pediatric clients with this disorder and their families in many different healthcare arenas, such as in radiology departments, ambulatory care, and acute and home care settings. The purpose of this article is to review current literature on this disease and summarize information useful to nurses.
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