Prevention of obesity

Recommendations for prevention are well known and enough simple. Healthy lifestyle, healthy eating, physical activity - under physical activity it is understood to perform the morning gymnastics, move (at least 10,000 steps per day), etc.

Proper and healthy diet involves performing simple and affordable rules. Feed on time, do not overeat, do not drink water from under the tap, but to use high-quality filters for water, do not eat dry.

Do not abuse after dense food by carbonated water. After a meal, sodium bicarbonate contained in the gas is reacted with a hydrochloric acid that is actively secreted in the stomach. This leads to the selection large number Carbon dioxide. Its increased pressure and excess of food cover the entrance to the stomach, create a bloating and pain. Eating tea after eating dilutes gastric juice and, accordingly, worsens digestion.

Children need compliance with the rules of feeding and regular control of the physical development of the child by systematic measurement of growth and body weight. It is important to early detection and treatment of diseases accompanied by hypothalamic and endocrine obesity.

Work plan

A) conducting research

Preparing for research (questionnaire, equipment training);

Study (survey, weighing, growth measurement, power monitoring);

Analysis of the data obtained;

Building tables, charts;

D) drawing up a presentation for learning students and patients measures to prevent obesity.

Structure and research results

a) solving the 1st task, which concerns the study of the health and factors of its determinants, we concluded that health determines the social order. A healthy person harmoniously feels in society, which allows him to work, develop, educate children.

The factors that determine it are as follows:

Moderate workload in production,

Material well-being,

Compliance with sanitary and hygienic standards,

Favorable psychological climate

Responsibility for your health

Healthy lifestyle.

b) solving the 2nd task, we allocated risk factors leading to the development of obesity.

Irreversible risk factor:

Hereditary predisposition to overweight;

Diseases of metabolism;

Diabetes;

Endocrine and cardiovascular diseases.

Reversible risk factors:

Irrational nutrition (the abuse of calorie food, food in dry, semi-finished products, power disorders);

Hydodine.

c) solving the 3rd task concerning optimal techniques for determining obesity, we decided that the main techniques within the framework of this educational institution rationally use: Questioning, measurement of growth and weight. Observation of the appearance of students, their nutrition in the buffet, in the way of life; Counting body mass index by formula:

BMI \u003d body weight (kg.) / Height (in meters)

d) solving the 4th task concerning the determination of the degree of obesity. Weighing and determination of students' growth was carried out (Appendix 1). According to the formula, we determined the degree of overweight (body mass index) and analyzed them.

A total of 200 people were examined. Overweight (resource) have 32 people.

Obesity I degree - 10 people.

e) solving the 5th challenge to identify the risk factors of obesity among students, we conducted a survey of 200 students, the main directions of which were:

Multiplicity of meals and regularity;

Caloric content of used products;

The presence of a full breakfast and lunch, the possibility of their preparation;

The presence of diseases that are factors of risk of obesity, and overweight in close relatives;

Nutrition balance;

Motor activity and its types, visiting the sports sections;

Eating preference fast cooking in the diet (chips, crackers, semi-finished products);

Weight control;

The presence of bad habits.

Were observation of students' nutrition in the buffet of schools and hostel, motor activity.

Revealed:

Breakfast of students - sandwich, tea or coffee (many do not have breakfast);

Lunch in the buffet - chips, crackers, carbonated drinks, tea, sandwiches, pizza;

Dinner - semi-finished products;

Classes in the School until 16:55;

The routine of the day in the hostel: from 17:00 Son until 19:00, rest in bed and a TV, food Tuchomatka. From 19:30 to 21:00, students are engaged in computers, dense high-calorie food for the night.

A total of 200 students are prohibited.

Revealed: out of 200 students, 130 have an irreversible risk factor for the development of obesity - hereditary predisposition.

This group of students was highlighted by us as a group of special risk of obesity. To analyze the risk factors, we analyzed their questionnaires and the results of the body mass index.

Revealed: out of 130 students, all students have a hereditary predisposition (irreversible factor).

Excess weight have 32 people.

Obesity I degree - 10.

The risk of deterioration in the health of these students increases the presence of revealed obesity risk factors identified:

Unbalanced food 116 people;

Hypodynamia 20 people;

Smoking 20 people.

Today we are increasingly meeting children whose weight is clearly exceeding medical standards. What diseases are overweight? How does he affect the mental health of the child? What are the causes of obesity in children? How to prevent it?

Severe consequences of overweight

Parents should be aware that childhood obesity may have difficult consequences. It significantly increases the risk of developing diabetes, liver diseases and gallbladder, hypertension, infertility and other chronic diseases. People, since childhood, suffering obesity, atherosclerosis, ischemic heart disease, myocardial infarction or chronic heart failure, characteristic of the elderly, can develop atherosclerosis. With overweight, the child often suffers snoring and other sleep disorders. Obesity negatively affects the psychological state of the child: excess weight generates in children and adolescents insecurity, significantly reduces self-esteem, which leads to problems with study, and sometimes causes peer ridicule and, as a result, leads to isolation and depression.

Causes of obesity in children

Most often, overweight in children is the result of an improper nutrition and a low-lifestyle, but it can also be caused by diseases of an endocrine system or other serious health problems. The main risk factors for the occurrence of obesity are the following.

• Eranny food
  If the child regularly uses high-calorie, fatty and sweet food (fast food, snacks, chips, confectionery, baking, etc.), it can lead to overweight. And if sweet carbonated drinks, ice cream, cream desserts and other sweets are added to this, the risk of obesity increases even more.
• Sedentary lifestyle
  The lack of physical exertion contributes to the accumulation of excess weight, because In this case, the child burns the calories much less than getting with food. If a child spends a lot of time from the TV, behind the computer or for a long time plays video games, such a lifestyle also contributes to the development of obesity.
• Healthy factor
  If family members suffer overweight, this is an additional risk of obesity risk in children, especially if there is always high-calorie food in the house, which is available at any time, and the child leads a sedentary lifestyle.
• Psychological factors
  Children and teenagers, as well as adults, tend to "eat" such psychological problems as stress, troubles or strong emotions, and sometimes eat just like that, from boredom. Sometimes the cause of overeating is the disadvantage or absence of parental attention, and extra calories obtained from food lead to overweight.

For medical issues, be sure to pre-consult your doctor

The article is provided by the site "Medical",
magazine "Country of Health"

Comment Article "Overweight in children: reasons, prevention and treatment"

The terrible picture in the body of the article is this, lower. It was easy to leave one, without the rest of the text and the title of the article. And everything would be clear. On the table in children of Coca-Cola (or Pepsi, I do not see the difference - and then, and other rapid car enthusiasts have long adapted for their needs - as the flushing of engines - corrosive acids). Everything else is the so-called fast food - what we call fast food is and the adult organism is not under the power to digest without prejudice to yourself, and a child who has everything grow and develops ... And what do children eat in schools? And they do nothing there. Because the tastes are already formed to another - not on casserole and porridge, but on chips, nuts, crackers with glutamate and everything that has packaging. That's what they eat, running on change in the next store. We, parents, terrify, looking at the TV screens, where America and its ordinary inhabitants are shown at 100 kg, regardless of age. And do nothing or can not do anything, oppose. There is no national program (Dr. Bormental and the country of slender - not to the account, although it is necessary to pay tribute to the commercial vein of the ear organizers). In sports, our best of the best from the country is far from the rest of the planet with all that then talk about the average Russian, and the sport is far from the priorities of our national policy. If the Soviet times of sports sections were at every corner, now parents do not know where to attach the Chado-preschooler.

2012-05-28 28.05.2012 00:45:20,

It is observed in people of any age, while it has a negative impact on the functioning of the body, in particular - to the work of the cardiovascular system. The prevention of obesity is necessary at any age, otherwise it is possible to spoil your metabolism since childhood and has a whole life with excess weight and many concomitant diseases.

Causes of obesity development

Allocate two main reasons that contribute to the development of obesity:

• improper nutrition in combination with a low-effective way of life;
• the presence of endocrine diseases (diseases of the liver, adrenal glands, thyroid gland, ovaries).

The hereditary factor has a great influence. In adolescence, children often allow their lives on Samotek: lead a sedentary lifestyle, use an excessive amount of harmful meal.

The abundance of fast food, various carbonated drinks, sweets, carrying out free time at the computer contributes to the wrong time of the day and the lifestyle of children. Such a pastime slows down the metabolism, contributes to the development of pathologies in all systems of the body and provokes an appearance in an excess weight.

Affect the correct ratio of growth and weight, but much less often the reason for the appearance of excess weight. Prevention of obesity in children and adults will prevent deterioration in health and external view.

What factors contribute to excess weight

In the absence of genetic predisposition and endocrine pathologies, obesity causes the following factors:

• lack of necessary physical activity;
• frequent stresses and strong experiences;
• incorrect nutrition - disorders of food behavior that lead to the development of bulimia, anorexia and other diseases;
• consumption of a large amount of inability to carbohydrates, products with high sugar content;
• violation of sleep mode, in particular - lack of space;
• using drugs that affect the work of the central nervous system, stimulating or coating it.

In very rare cases, obesity can be the consequence of surgical intervention (for example, the removal of ovaries) or injuries (when damaged pituitary). The defeat or bark of the adrenal glands also provokes an excess weight. Prevention of obesity from an early age will avoid health problems appearing if excess weight.

How to calculate body mass index

Obesity is classified according to BMI indicators. Calculate this figure can be alone. It is enough to know your weight and growth.

It is necessary to divide the body weight on the growth raised to the square. For example, a woman has a weight of 55 kg with a height of 160 cm. The calculation will look like this:

55 kg: (1.6 x 1,6) \u003d 21.48 - In this case, the weight perfectly corresponds to the growth of the patient.

BMI, exceeding the indicator 25, indicates extension, but does not carry health hazards. The prevention of obesity should begin as early as possible, and not when BMI is already more than 25. When a person is just beginning to rise in the body weight, stop this process is much easier than any of the stages of obesity.

Decoding BMI

Considering its indicator, it is necessary to determine whether it is an option for the norm or not:

• if the calculation turned out to be less than 16, this indicates a strong body weight deficit;
• 16-18 - insufficient weight, most often all girls are striving for this indicator;
• 18-25 - the ideal weight for a healthy adult;
• 25-30 - the presence of excess weight, which is not harmful to health, but externally spoils the shape of the figure;
• more than 30 - the presence of obesity of different degrees requiring medical intervention.

If excess weight, it is better to immediately change your lifestyle and restore optimal parameters. Otherwise, the weight will gradually increase, and it will later be very difficult to return to permissible norms. Prevention of obesity in children should begin with early age. That is, you need to carefully monitor the nutrition and activity of your children.

Types of obesity

Depending on the localization site of a larger percentage of excess weight, the following types of obesity are distinguished:

• Upper (abdominal) - the fatty layer is increasing mainly in the upper part of the body and on the stomach. This type is most often diagnosed in men. Abdominal obesity has a negative impact on the overall state of health, provoking the appearance of diabetes, stroke, heart attack or arterial hypertension.
• Nizhny (femoral-butodic) - fat deposits are localized in the field of hips and buttocks. Diagnosed mainly in the female. Provokes the appearance of venous insufficiency, diseases of the joints and spine.
• Intermediate (mixed) - fat is increasing evenly throughout the body.

Types of obesity can be correlated with the types of the shape. Thus, for the form "Apple" will be characterized by the appearance of excess weight in the upper part of the body and on the stomach, and the body of the type "pear", fat deposits will be localized mainly in the field of hips, buttocks and abdominal nose.

Prevention of obesity in elderly patients is necessary, since at this age there are violations in the work of the endocrine system and the metabolism is reduced.

Obesity classification

Primary obesity develops with a violation of nutrition and a sedentary lifestyle. When an excessive amount of energy accumulates in the body, which has nowhere to spend, it accumulates in the form of fatty sediments.

Secondary obesity is a consequence various diseases, injuries, tumors that affect the work of the organization's regulation system.

The endocrine is an increase in the patient's weight due to violations in the work of the organs of the endocrine system, in particular, the thyroid gland, adrenal glands or ovaries. Recommendations for the prevention of obesity in this case can only give a qualified doctor who studied the patient's history and conducted all the necessary surveys.

Diagnosis of obesity

As diagnostic activities are used:

• body mass index;
• fat and low-fat tissues in the body;
• measurement of body volumes;
• measurement of the total subcutaneous fatty fiber;
• blood test - used to diagnose diseases that cause excess weight.

Based on the results obtained, the doctor can make a conclusion about the presence or absence of alert. Prevention of obesity in children and adolescents contributes to the preservation of the normal operation of the body in adulthood and old age.

Treatment of obesity

In some cases, weight loss is not observed even when complying with healthy nutrition and sufficient physical activity. In this case, doctors can prescribe suitable pharmacological preparations that contribute to weight loss. Prevention of obesity and diabetes mellitus is necessary in the presence of cardiovascular diseases in a patient.

If the patient in obesity has developed a respiratory or musculoskeletal system, it is necessary to take medicines that are decisive first of all these problems. The reception of such drugs should be combined with a change in the usual lifestyle, and, if necessary, with the use of drugs that stimulate weight loss.

It is prohibited without consulting a doctor to choose and take preparations for weight loss. Admitted funds do not provide a proper effect, and effective drugs must be appointed only after a full examination by a qualified physician. Due to the large number of contraindications and side effects, the reception of such funds should be carried out under the supervision of the doctor in a strictly designated dosage.

The consequences of unbearable obesity

If it does not diagnose the reason that caused the appearance of excess weight, and serious complications may appear on the appearance of obesity. The prevention of obesity in old age is necessary to prevent the emergence of concomitant diseases and states, such as:

• ailments of the joints and bones;
• an increase in blood pressure;
• liver disease and gallbladder;
• sleep disorders;
• depression;
• increasing blood cholesterol;
• asthma;
• disorders of food behavior;
• diabetes;
• cardiovascular diseases;
• early death.

Improving body weight negatively affects the general condition of the patient and its health. The greater the more difficult the organism to cope with its functions. Breathing, digestion, blood circulation processes are violated, brain activity decreases, diseases of the sexual sphere and disorder of reproductive function appear.

Diet in obesity

In obesity, the doctor sends a patient to a nutritionist, which takes into account the preferences of a child or an adult and makes up a new diet. The prevention of obesity in adolescents should include a psychological factor in combination with basic medical recommendations. The most important and effective recommendations are:

• restriction of consumption of oily, fried and high-calorie food, semi-finished products, sodes, products with high sugar content;
• use of low-fat dairy products;
• the basis of the daily diet should be fresh vegetables and fruit;
• meat and fish are preferred non-fat varieties cooked for a pair, baked or boiled;
• restriction of the use of products with high sodium content;
• reduce the number of refined carbohydrates (bread, rice, sugar);
• eat food at the same time;
• be sure to have breakfast;
• replace any drinks with clean water and drink 2-3 liters per day.

It is necessary to purchase mainly healthy products and prepare yourself at home. When developing severe obesity, these recommendations will not give a good effect, it will take strict control of a nutritionist and compliance with a tough diet.

Physical activity in obesity

Improve the result of dietary nutrition will allow moderate physical exertion. It is necessary to choose the optimal sport, in which the body will not be brought to exhaustion. Otherwise, it will be quite difficult to motivate yourself into classes. Sports must bring pleasure and give energy and positive emotions.

Prevention of obesity in children should include a decrease in the time spent at a computer or TV, up to 1-2 hours per day. The rest of the time you need to be active, attend sports clubs or do at home, empty even it will be cleaning the house, jogging, swimming or fitness. Everyone chooses classes to taste.

Obesity: Treatment and Prevention

Obesity treatment should begin on early stage. In this case, compliance with the diet, an active lifestyle and healthy sleep will be able to normalize the weight and return the desired outlines. In rare cases, drugs may need to reduce weight or surgery, during which a decrease in the volume of the stomach.

To prevent the development of obesity, you must adhere to several main points:

• to give preference to healthy food and not use more than it is necessary for the full work of the body;
• lead an active lifestyle - if the work is sitting, then in free time It is worth doing sports, more walking in the fresh air;
• it is important to get enough sleep well and avoid stressful situations that can provoke disorders in the exchange of substances or the work of the endocrine glands.

Compliance with all rules will prevent obesity. Causes, prevention and treatment of respected obesity should be interrelated and aimed at changing the lifestyle and return of the former volumes of the body.

- Chronic disruption of metabolism, accompanied by excessive deposits of adipose tissue in the body. Obesity in children is manifested by an increased mass of the body and predisposes to the development of constipation, cholecystitis, arterial hypertension, dyslipidemia, insulin resistance, dysfunction of flooring glands, arthrosis, flatfoot, sleep apnea, bulimia, anorexia, etc. The diagnosis of child and adolescent obesity is raised on the basis of growth measurement, Body masses, CMT and exceeding actual indicators over the required (according to central tables). Treatment of obesity in children includes dietherapy, rational physical activity, psychotherapy.

MKB-10.

E66. Obesity

General

Obesity in children is a condition in which the actual mass of the child's body exceeds the age standard by 15% or more, and the body mass index ≥30. These studies indicate that about 12% of Russian children have overweight, and obesity is 8.5% of children living in cities, and 5.5% in rural areas. All over the world, an epidemic increase in dissemination of obesity among children is noted, which requires a serious attitude to this problem by pediatrics and children's endocrinology. Almost 60% of adults suffering from obesity, overweight problems began in children's and adolescence. The progression of obesity in children leads to development in the future cardiovascular, endocrine, metabolic, reproductive disorders, diseases of the digestive tract and the musculoskeletal system.

Causes of obesity in children

Obesity in children has a polyethological nature; In its implementation plays the role of complex interaction of genetic and medial factors. In all cases, the basis of obesity in children is a power imbalance due to increased consumption and reduced energy spending.

It is known that in the presence of obesity in both parents, the likelihood of such a violation in a child is 80%; If there is obesity, only the mother has 50%; Only the father is 38%.

A group of risk to develop obesity make up children having an increased body weight at birth (more than 4 kg) and redundant monthly weight gain in artificial feeding. In infants, obesity can develop against the backdrop of the child's overlooking with high-calorie mixtures, violations of the rules for administering dust.

According to anamnestic data, the development of obesity in most children is associated with a power impairment and a decrease in physical exertion. Usually, in nutrition of children with excess body and obesity, easily durable carbohydrates predominate (bakery products, sweet desserts) and solid fats (fast food), sweet drinks (juices, soda, teas) with insufficient use of fiber, protein, water. At the same time, most children behave a low-wear lifestyle (do not play in mobile games, do not engage in sports, do not attend physical education lessons), spend a lot of time with a TV or computer, experience intensive mental load contributing to hypodynine.

Obesity in children may not only be a consequence of constitutional predisposition and alimentary causes, but also serious pathological conditions. Thus, obesity is often found in children with genetic syndromes (Down, Prader-Vilia, Lawrence-Muna-Bidla, Coen), endocrinopathy (congenital hypothyroidism, Incenco-Cushing syndrome, adiposo-genital dystrophy), the damage to the central nervous system (as a result of CHT, Meningitis, Encephalitis, neurosurgical operations, etc.).

Sometimes in the history of children, the relationship of obesity with external emotional factors is traced: admission to school, an accident, the death of relatives, etc.

Classification

Thus, taking into account the causes of the occurrence of two forms of obesity in children: primary and secondary. In turn, primary obesity in children is divided into exogenous constitutional (associated hereditary predisposition) and an alimentary (associated errors in nutrition). With constitutional obesity, children are inherited not to the abundant weight itself, but the features of the flow of metabolic processes in the body. Alimentary obesity most often occurs in children in critical periods of development: early childhood (up to 3 years), preschool age (5-7 years) and period of puberty (from 12 to 16 years).

Secondary obesity in children is a consequence of various innate and acquired diseases. The most common type of secondary obesity is the endocrine obesity, accompanying the diseases of the ovaries in girls, thyroid gland, adrenal glands in children.

Criteria for determining obesity in children so far remains the subject of discussion. Gaivoronskaya A.A. Based on exceeding the mass of the body of a child normal for this age and the growth of values, 4 degrees of obesity in children highlights:

• Obesity I degrees - the mass of the child's body exceeds the norm by 15-24%
• Obesity II degree- the mass of the child's body exceeds the norm by 25-49%
• Obesity III degree - the mass of the child's body exceeds the norm by 50-99%
• Obesity IV degree - body weight exceeds permissible agent by more than 100%.

In 80% of children detect the primary obesity of the I-II degree.

Symptoms of obesity in children

The main sign of obesity in children is an increase in the layer of subcutaneous fatty fiber. In early age children, there can be facilities of primary obesity, the delay in the formation of motor skills, a tendency to constipate, allergic reactions, infectious morbidity.

With an alimentary obesity in children there are excess fat deposits in the abdomen, pelvis, hips, chest, back, face, upper limbs. At school age, such children have shortness of breath, a decrease in physical exhaust tolerance, increased blood pressure. The central age in a quarter of children is diagnosed with metabolic syndrome characterized by obesity, arterial hypertension, insulin resistance and violation of lipid metabolism (dyslipidemia). Against the background of obesity in children often develops impaired uric acid exchanging and dysmetabolic nephropathy.

Secondary obesity in children proceeds against the background of the leading disease and is combined with typical symptoms of the latter. So, with congenital hypothyroidism, children begin to keep the head, sit and walk; They are shifted by the timing of teething. The acquired hypothyroidism is more often developing during puberty due to iodine deficiency. In this case, in addition to obesity, children have fatigue, weakness, drowsiness, reduced performance at school, dry skin, disruption of the menstrual cycle in girls.

Characteristic signs of Kushingoid obesity (in the syndrome of Itsenko-Cushing in children) are fat deposits in the field of abdomen, face and neck; At the same time, the limbs remain thin. Girls in the pubertal period there are amenorrhea and girsutism.

The combination of obesity in children with an increase in the mammary glands (gynecomastia), galattere, headaches, dysmenorrhea can indicate the presence of prolactin.

If, in addition to overweight, the girl worries oily skin, acne, overwhelming hair growth, irregular menstruation, then with a high degree of probability, it can be assumed by a polycystic ovarian syndrome. The boys with adiposogenital dystrophy there is obesity, cryptorchism, gynecomastia, underdevelopment of the penis and secondary sexual signs; Girls are lack of menstruation.

Complications

The presence of obesity in children is a risk factor early Development A number of diseases - atherosclerosis, hypertensive disease, angina, type 2 diabetes mellitus. On the part of the digestive system, the formation of chronic cholecystitis and HCB, pancreatitis, constipation, hemorrhoids, fat hepatosis, and in the future - liver cirrhosis. In children with overweight and obesity, food disorders (anorexia, bulimia) and sleep disorders (snoring and sleeping apnea syndrome) occur.

Increased load on the musculoskeletal system causes development in children with obesity of dysfunction of posture, scoliosis, arthralgium, arthrosis, hughus deformation of stop, flatfoot. Obesity in adolescents often serves as depression, ridicule on the part of peers, social isolation, deviant behavior. In women and men suffering from obesity since childhood, there is an increased risk of infertility.

Diagnosis of obesity in children

The clinical assessment of the obesity and degree of its severity in children includes the collection of anamnesis, finding out the breastfeeding method and the characteristics of the child's nutrition at present, clarifying the level of physical activity. In an objective examination, the pediatrician produces anthropometry: registers growth rates, body weight, waist circle, thighs, body mass index. The data obtained are compared with special centeal tables, on the basis of which the excess body mass is diagnosed or obesity in children is diagnosed. In some cases, for example, with mass examinations, a method for measuring the thickness of the skin fold, determining the relative mass of adipose tissue by the method of bioelectric resistance.

To clarify the reasons for obesity, children with overweight should be consulted by a children's endocrinologist, a children's neurologist, a children's gastroenterologist, genetic. It is advisable to additional study of the biochemical analysis of blood (glucose, glucose-tolerant test, cholesterol, lipoproteins, triglycerides, uric acid, protein, hepatic samples), hormonal profile (insulin, prolactin, tong, T4, blood cortisol and urine, estradiol). According to the testimony, the ultrasound of the thyroid gland, Rag, EEG, MRI pituitary gland is performed.

Treatment of obesity in children

The amount of medical care to child-suffering children includes a decrease in body weight, treatment of related diseases, maintain the result achieved and preventing a set of excess weight.

First of all, an individual diet is selected with obesity, which suggests the reduction of daily calorage due to animal fats and refined carbohydrates. It is recommended that the 5-time (sometimes 6-7-time) power supply is recommended, parents are trained to calculate the rate of daily kilocalorius. Simultaneously with the correction of food, the organization of a rational motor regime is carried out: For young children, walks and mobile games are recommended, and starting with preschool age - Sports (swimming, cycling, etc.). Dietherapy is carried out under the guidance of a pediatrician or a nutritionist; Power control and motor activity Children suffering from obesity is assigned to their parents.

When obesity, children can be performed needleflexotherapy, leafc, hydrotherapy, psychotherapy. In the presence of concomitant diseases, the child requires the help of a children's endocrinologist, a children's gastroenterologist, a children's gynecologist, a children's cardiologist, a children's orthopedic, neurosurgeon, a children's psychologist.

Prevention

Warning of the obesity epidemic among children is a task that requires the integration of parents' efforts, representatives of the medical community and the field of education. The first step on this path should be an understanding of the parents of the importance of rational nutrition in childhood, the upbringing of the right food addictions in children, the organization of the child's day, with the obligatory inclusion of walks in the fresh air.

Other an important point The prevention of obesity in children is the grafting of interest in physical culture, availability of sports at school and at the place of residence. It is important that the parents be an example of a healthy lifestyle, and not authoritatively demanded it from the child. The development of screening programs to identify obesity and its complications among children and adolescents is necessary.

Manipulations performed by a medical sister

Measurement of the growth of the patient

Equipment: ROSTER, Handle, History, Gloves, Napkin.

Preparation for the procedure

2. Explain to the patient the course of the upcoming procedure, to obtain consent.

3. Prepare equipment.

Procedure

4. Suggest the patient to stand on the platform of the header with his back to the rack with a scale, so that it concerned it with three points (heels, buttocks and inter-tubes).

5. Stand on the right or left of the patient.

6. Slightly tip the patient's head so that the upper edge of the outer auditory passage and the lower edge of the orphanage was located on the same line, parallel to the floor.

7. Lower the patient's head tablet. Fix the tablet, ask the patient to lower your head, then help him get away from the header. Determine indicators.

Completion of the procedure

8. Report the patient the measurement results.

9. To put on gloves, throw a napkin from the player's site, remove the gloves, wash your hands.

10. Help the patient to get away from the player's site and record the result in the adopted documentation.

Determining body weight

Equipment:scales, napkin, handle, medical history, gloves.

Preparation for the procedure

1. Collect information about the patient.

2. Explain to the patient the course of the upcoming procedure, understanding the purpose and research preparation: to be carried out in the morning, on an empty stomach, after visiting the toilet

3. Get consent.

4. Check the adjustment of the scales: open the shutter located above the panel and adjust the scales with screw; The level of the scale of the scales on which. All hyris are in a zero position, must coincide with the control point.

5. Close the shutter.

Procedure

6. Help the patient get into the center of the site, putting on it a napkin.

7. Open the shutter and move the Giri on the rocker boards to the left until it falls into the checkpoint.

8. Close the shutter.

Completion of the procedure

9. Tell the patient the result.

10. To put on gloves, throw away the napkin from the site of the scales, remove the gloves, wash your hands.

11. Record the result in the adopted documentation.

Body mass index

Proper body weight is calculated by ketle formula

CMT \u003d mass (kg)

Growth (m) 2

Features of the nursing process in obesity

Possible patient problems:

Deficiency of information about the disease;

Concern about the appearance;

Excessive increase in body weight;

Reduced performance;

Psycho-emotional lability;

Drowsiness;

Increase in body weight;

Fatigue;

The risk of developing complications.

The purpose of the nursing process is to maintain and restore the patient's independence, satisfying the basic needs of the body. The medical sister informs the patient about the disease, the principles of treatment and prevention, conducts preparations for instrumental and laboratory research methods.

Nursing care for obesity patients includes:

Observation of the patient's condition;

Providing permanent psychological support;

Monitoring the observance of diet and treatment prescribed by a doctor, as well as identifying side effects of drugs;

Conversation with a patient about obesity prevention measures.

Practical part

Observation of practice 1

In the endocrinological department there is a patient Ivanova A., 50 years with a diagnosis, obesity of the II degree. Complaints on fast fatigue, reduced performance, drowsiness, there is a significant increase in body weight by 30%, shortness of breath, a decrease in physical activity, constipation. Lesse: C. Patient condition is satisfactory. The skin is dry, the temperature of 36.1 subcutaneous fat layer is expressed excessively. Pale face, fined, hell - 100/70 mm Hg. Art., heart rate - 60 / min, ChDD - 18 / min. Height 168 cm, weight 92 kg.

Exercising first stagenursing process - nursing examination, Medical documentation was filled - a primary assessment list (see Appendix 1, Table 2). After analyzing the primary assessment sheet, complaints were revealed for quick fatigue decrease in performance, drowsiness, there is a significant increase in body weight by 30%, s. Idry, a decrease in physical activity, constipation, temperature 36.1 patient's condition satisfactory. The skin is dry, the subcutaneous fat layer is expressed excessively. Pale face, fined, hell - 100/70 mm Hg. Art., heart rate - 60 / min, ChDD - 18 / min.

Based on the results obtained, we turn to the implementation the second stagenursing Process - Disrupted Violated Needs defining problems- Real, potential, priority.

True problems:fast fatigue decrease in performance, drowsiness, there is a significant increase in body weight by 30%, shortness of breath, a decrease in physical activity, constipation. Potential problems:risk of complications.

Priority problem: Obesity II degree.

After identifying the patient's problems, proceed to implement third stage nursing process - planning nursing interventions. It is necessary to observe the patient's condition, conduct conversations about the need to respect the diet and reception of drugs. Control over blood pressure, pulse, patient preparation for ECG, ultrasound, urine and blood research.

On the fourth stagenursing process - realization of planarestrinsky care(See Appendix 1, Table 3):

3. Monitor the regular intestine function.

5. The nurse is systematically monitored by ChDD, CSS, Hell and Pulse.

6. The medical sister should give a sore elevated position, free from shocking clothes, ensure the maximum influx of fresh air.

7. The medical sister must provide permanent psychological support.

8. Conduct with a patient about obesity prevention measures.

9. The medical sister doses the physical and emotional load of the patient during the organization of labor and recreation.

Fifth stagenursing process - evaluation of the results of nursing interventions: The patient notes a significant improvement in the state, a decrease in body weight. The goal is achieved.

Observation of practice 2

Patient Dmitriev S., 64 years old, with complaints about sharp compressive pains for the sternum, which apply to the left shoulder and the epigastric area. Such pain arose for the first time, on the way to work. Obesity III degree. Objectively: increased nutrition. Skin pale, wet. Cyanosis lips. Pulse 92 per minute, rhythmic, satisfactory filling. Hell - 155/80 mm Hg. Art. Chdd - 20 per minute, temperature 36.3. Heart boundaries: right - on the right edge of the sternum, the left is 1 cm in the left of the left middle-clearable line. Heart tones are muffled, no noise.

Against the background of obesity, the patient developed myocardial infarction.

Algorithm actions of nurse

Call a doctor with the purpose of providing qualified assistance;

Give a patient a convenient position lying on the couch in order to reduce pain;

Provide fresh air access or oxygen therapy in order to reduce hypoxia;

To ensure the reception of nitroglycerin under the tongue three times in 5-10 minutes in order to expand the coronary vessels (under the control of blood pressure), the reception of aspirin 0.05 in order to reduce platelet aggregation;

Insert the physician drugs by appointment: (morphine, promidal for adequate anesthesia, heparin in order to prevent repeated thrombus and improving microcirculation, lidocaine for the purpose of prevention and treatment of arrhythmias);

Ensure the removal of ECG, taking blood into common and biochemical analysis to confirm the diagnosis and conducting a tracker test;

Provide the patient's transportation in the position of the Loku in the intensive care unit.

conclusions

Comparing, two cases in obesity patients noted differences in medical care:

In the first case, the exercise of the nursing process is carried out with the identification of patient problems and draw up a care plan for identified problems.

In the second case, the nursing process is to provide urgent prefigure Related to the deterioration of the patient's condition.

Conclusion

Having studied the necessary literature and analyzing two cases, it can be drawn: the knowledge of the etiology of obesity, the clinical picture and the features of the diagnosis of this disease, methods of examination and preparation for them, the principles of treatment and prevention, complications, manipulations will help the medical sister to carry out all the stages of the nursing process.

Having deeply examining the information obtained, it is possible to conclude that the goal of the work is achieved. In the course of it revealed that the use of all stages of the nursing process, namely:

I Stage - Assessment of the patient's condition;

Stage stage - determination of patient problems;

III stage - planning of nursing interventions;

IV Stage - the implementation of a composed plan of nursing interventions;

V stage - assessment of the results of listed steps,

allows you to improve the quality of nursing care.

The medical sister, the responsibility of which includes patient care, should know all the rules of care, skillfully perform therapeutic procedures. Obesity treatment mainly depends on the careful proper care, compliance with the regime and diet. In this regard, the role of a medical sister increases in the effectiveness of the treatment.

LITERATURE

1. Kacharskaya E. V. Nursing business in therapy. "Cardiology" // 2010. 125 p.

2. Koryagin N. Yu. Organization of specialized nursing care // 2009. 211 p.

3. Mukhina S. A., Tarnovskaya I. I. Practical guide to the subject of the "Basics of Nursing" // Publisher "Gootar-Media" 245 p.

4. Women N.V. Basics of Nursing. Manipulation algorithms // 2010. 138 p.

5. Women N.V. Basics of Nursing. Situational tasks // 2009. 235 p.

6. Budrov S.A., Berkovskaya M.A. Modern aspects of obesity therapy. // Handbook of a polyclinic doctor. 2008. - №.11. - from. 58.

7. Zhikhareva N.A. Organizational approaches to the formation of an intact-agency system of quality management of nursing assistance / I.G. Novocrechenova, I.V. Novokreshov, N.A. Zhikhareva // Saratov Scientific and Medical Journal. - 2007. - №4. - p.23-29

ATTACHMENT 1

Table 1. Plan of nursing care

Motivation

1. Ensure physical and mental peace, bed comfort.

For a comfortable condition of the patient.

2. The medical sister will ensure compliance with diet number 8 with the limitation of cholesterol and the additional content of vitamins A, E.

Normalization of metabolic processes, increasing the body's protective forces.

3. Follow the regular function

intestines.

To prevent constipation.

4. The medical sister will provide the hygienic content of patients (arms, shift in linen daily).

To ensure a comfortable state.

5. The medical sister provides control of drug reception.

Control the reception of drugs by the patient.

6. The medical sister systematically observes the respiratory frequency, to give a sore elevated position, free from shocking clothes, ensure the maximum influx of fresh air.

To reduce shortness of breath.

Body mass index

Compliance between the mass of man and its growth

16 or less

Pronounced body weight

Insufficient (deficit) body weight

Excess body mass (resource)

Obesity of the first degree

Obesity of the second degree

40 or more

Third degree obesity (Morbid)