An Elementary Nursing Paper written November 6, 2009 by student nurse, +Ronnie Kirchner
Nursing Health Promotion : Overweight and Obese Patients
The human body is a system of processes that requires “fuel” as an energy source. The fuel or nutrients that our bodies require to intake and metabolize for energy can be measured as calories. An imbalance in the caloric intake combined with a low caloric metabolic rate can start to accumulate as lipid storage or fat cells. Using the standard Body Mass index weight and height ratio are calculated to determine if an individual is considered obese or overweight. A large percentage of Americans are considered to be obese or overweight. Americans do not educate and emphasize proper diet, exercise and healthy lifestyles which leave them prone to obesity or becoming overweight. The Nurse’s Role in this issue of Healthy People 2010 is to promote health by implementing the nursing process, with the end ultimate goal of increasing ones life expectancy.
Obesity and overweight American individuals is an issue embedded into our culture. According to the Center of Disease control (2007), over 72 million people in this country in 2005-2006 were considered to be overweight. The impact of being obese is associated with an increased of life threatening risk’s and conditions including, diabetes, cardiovascular disease, hypertension, and certain cancers, and with increased risk of disability and an elevated risk of mortality (Center of Disease, 2007). As we look further into the issue and at the risks that are associated with being obese, we can also in turn see the financial effect of an obese and overweight population on its health care system. “Based on data from a study conducted by the Centers for Disease Control and Prevention and the Research Triangle Institute, approximately $147 billion is spent on treating illness related to obesity in the form of treatment and medication”( Splete, 2009). We can clearly see the significance of having an obesity problem in a population, its increase of health risk to the individual’s lifespan. It promotes a parasitic effect on its healthcare system as a whole in regards to manpower and the finances used to fund the treatment of illnesses that arise from being obese. In short, obesity and overweight is related to a number of complex factors such as a poor combination of lifestyle habits and genetics. We know that excessive weight gain is related to more calories consumed than the body burns with the excess calories stored as adipose tissue. We know that genetic factors can significantly influence how the body regulates the appetite and metabolic rate of an individual. In many cases obesity can be prevented with diet and physical activity combined into a healthy lifestyle. Nursing health promotions and nursing interventions can make a difference with this problem. Nursing health promotions can be utilized in many different settings in regards to preventing overweight and obesity such as hospitals, communities and educational settings. The Nurses will utilize the most fundamental yet powerful aspects of their roles: health promotion and primary, secondary and tertiary disease prevention.
The Nurse’s role and first intervention in Health People 2010: Obesity and Overweight will focus on primary disease prevention. According to Kozeir and Erb (2008) ,primary prevention focuses on health promotion and protection against specific problems. The purpose of Primary prevention is also to minimize the possibility of risk to an individual. Specifically, the intervention will be education. This education will need to be implemented over the entire lifespan. The nurse will focus the education of what a healthy lifestyle consist of with emphasis on diet and physical activity and preventative measures. In addition, the nurse will inform the individual of the negative effects obesity and overweight have on body systems. The Nurse may work closely with a dietician as a resource and obtain information on healthful diets. The dietitian can counsel the client on a healthful eating pattern as the nurse provides support and reinforces the importance of maintaining a healthful eating pattern (Ignatavicius,Workman,2009). The importance of physical activity goes beyond preventing obesity and promotes a healthy lifestyle. Working in conjunction with a physical therapist, the nurse’s major intervention is to encourage and increase the type and amount of daily exercise to create a caloric deficit. Exercise combined with diet interventions produces more weight loss than just dieting alone (Ignatavicius ,Workman ,2009). The positive relationship that can be established between an individual and a nurse can culture an understanding of the importance of primary prevention. The results of this intervention will be healthier and more educated clients who will be able to prevent secondary illnesses that are a result of obesity.
If an obese or overweight individual with a disease or illness is admitted into an acute care setting such as a hospital the Nurse’s role will be to assess them and plan to utilize a secondary prevention technique. Secondary prevention focuses on early identification of health problems and requires an intervention to alleviate health problems ( Kozier, & Erb ,2008). Nurses need to take advantage of this opportunity to promote health and identify a client’s risk to obesity or illnesses that could have derived from obesity and overweight. Many nursing interventions can be implemented, such as Education, consulting with a physical therapist, consulting with a dietician and consulting a physicians order if drug therapy would be beneficial. A primary role of a Nurse is an educator to the client. Education will continue to take place with emphasis on a healthy lifestyle and will be combined with other discharge procedures. Before consulting with a physical therapist, who will identify an adequate exercise regime for the client, it will be the Nurses responsibility to assess the client’s desire and attitude to participate in an exercise program, their preferred types of exercises and any limiting factors. (Ignatavicius Workman (2009). The nurse will consult with a dietician who can develop diet therapy. Diet therapy is personalized and is a result of close interaction and collaboration between the client, physician and the dietician. The diet should meet the client’s needs and habits and should be realistic. The role of the nurse will be to gain feedback from the client and evaluate their progress (Ignatavicius, Workman 2009).
The Nurse plays a large role in assessing the client and observing deviations from the norm. It will be the nurse’s responsibility to obtain a physician’s order for drug therapy. An indication for the use of drug therapy is a Body Mass Index above 27 with comorbidities (Ignatavicius ,Workman ,2009). The Nurse will be responsible in obtaining a physicians order for a drug therapy that can treat obesity and overweight by suppressing appetite or altering metabolism. The Nurse can follow through with the medication order, evaluate progress, and note any side effects.
Tertiary prevention is the goal of returning the individual to their optimal level of function through restoration and rehabilitation. (Kozier, B., & Erb, G. (2008) A variety of interventions the nurse should implement include connecting the individual to community support groups and encouraging follow up health appointments to appropriate health professionals such as a physical therapist. The Nurse should be a resource to the client providing any list of support groups. The chances of success in a weight control program are increased if additional support groups are available (Ignatavicius ,Workman 2009). The nurse should encourage the client to make follow up appointments with there physician to evaluate progress and nutritional status. The nursing intervention is to provide the individual with a list of professional organizations that can provide follow-up rehabilitation sessions in a ambulatory settings.
Healthy People 2010, obesity and overweight, has brought a widespread issue to the knowledge of healthcare professionals. The time has come for Nurses to become proactive in dealing with the root of many health issues that could be prevented. Nurses are in a important position that allows them to holistically promote and teach healthy lifestyles to a client. The nurse has the ability to be culturally sensitive to many different factors pertaining to the client’s needs and perspectives. A Nurse must be sensitive and understanding to cultural backgrounds, chronic diseases or medical diagnosis, education level and motivation pertaining to obesity and overweight. The nurse, who can acknowledge these barriers and work around them and find other resources to promote health, plays a unique role in Healthy People 2010. Nurses differ from physicians and other healthcare professionals in a number of ways that make them unique and powerful. For example, Nurses are at the front lines of care and at the bedside. Nurses are paid hourly and not by the number of patients they see. We as Nurses must start with the basics of nursing to solve a problem of this magnitude. Starting with the nursing process, nurses will implement their role at the bedside, in the schools, in the communities and in politics. The Nurse’s Role in this issue of Healthy People 2010 is to promote health by implementing the nursing process, with the end ultimate goal of increasing ones life expectancy.
Berman, A., PhD., Snyder, S. J., EdD., Kozier, B., MN., & Erb, G., RN. (2008). Health promotion. In Fundamentals of nursing (8th ed., pp. 276 – 277). New Jersey: Pearson Education.
CDC obesity among adults in the united states [Data sheet]. (2007, November). Retrieved October 14, 2009, from The Center for Disease Control and Prevention website: http://www.cdc.gov/nchs/data/databriefs/db01.pdf
CDC prices obesity at $147 billion annually [Press release]. (2009, July).
Retrieved October 13, 2009, from Centers for Disease Control and Prevention website http://www.cdc.gov/media/pressrel/2009/r090727.htm
Ignatavicius, D. D., & Workman, M. L. (2009). Inventions for clients with malnutrition and obesity. In Medical-surgical nursing: Patient-centered collaborative care (9th ed., pp. 13-75-1382). New York: Saunders Company.