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Pathopharmacological Foundations for Advanced Nursing Practice Pathopharmacological Foundations for Advanced Nursing Practice A. Investigated Disease Process Obesity is defined as having a body mass index or BMI of greater than 30. Obesity is not considered a disease but is a risk factor for other ...

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  • February 6, 2022
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  • 2021/2022
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Running head: PATHOPHARMACOLOGICAL FOUNDATIONS 1




Pathopharmacological Foundations for Advanced Nursing Practice

Darla Johnson

Western Governors University

,PATHOPHARMACOLOGICAL FOUNDATIONS

Pathopharmacological Foundations for Advanced Nursing Practice

A. Investigated Disease Process

Obesity is defined as having a body mass index or BMI of greater than 30. Obesity is not

considered a disease but is a risk factor for other diseases like heart disease and type 2 diabetes.

One third of American adults are obese with another one third considered overweight (BMI

greater than 25 but less than 30). Parents who are obese often have children who are obese due

to genetics and environmental effects: parents and children usually eat the same foods and have

the same exercise habits (McCance & Huether, 2014).

Obesity is an epidemic with no simple solution. It is a complex problem that is going to

take individuals, healthcare professionals, state and local organizations, policy makers, and

community leaders working together to create and maintain a healthy lifestyle and environment.

Resources are available through state and local programs for health recommendations.

Community support for healthy eating and active living in different settings can help reverse

obesity. A lifestyle change is the way to achieve and maintain a healthy weight (“Strategies to

Prevent Obesity,” 2015).

A1. Pathophysiology

Obesity is defined as a BMI greater than 30 and is also considered a metabolic disorder.

When an individual with susceptible genes to obesity takes in more calories than they burn off

then obesity can develop (McCance & Huether, 2014).

There are interactions of many cytokines, hormones, and neurotransmitters which makes

the pathophysiology of obesity very complex. Adipocytes are the cellular basis of obesity and

secrete numerous hormones and cytokines called adipokines. Adipokines help regulate food

consumption, the storage and metabolism of lipids, insulin sensitivity, and many others.

, PATHOPHARMACOLOGICAL FOUNDATIONS

Accumulation of visceral fat causes the adipocytes to not function properly and results in

changes in the regulation and interaction of the hormones. These changes in the adipokines and

other hormones and neurotransmitters take part in the causes and complications of obesity

(McCance & Huether, 2014).

A2. Standard of Practice

Recommended standards for a primary care giver is to calculate a patient’s BMI, using

height and weight, on annual visits or more frequently if needed. This is the first step in

identifying those who would need to be counseled on weight lose if the BMI is >25 (overweight)

or >30 (obese). A waist circumference should also be used as a possible indicator for higher risk

of type II diabetes and cardiovascular disease. Waist circumference limit is 40 inches or more

for men and 35 inches or more for women. Lifestyle change is the most important start for

weight loss. Guidelines for weight loss are based on the patient assessment and include: a) diet,

b) physical activity, c) behavioral counseling, d) pharmacological treatments, and e) bariatric

surgery. Patient options and any health issues are included in these guidelines (“New Obesity

Guidelines: Authoritative ‘Roadmap’ to Treatment,” 2013).

A2a. Pharmacological Treatments

Treatments for obesity are based on developing a weight loss plan to improve the

patients’ health and well-being. After consulting some primary care physician offices, results

show that evidence-based pharmacological therapies in my state were comparable to the

recommended standard guidelines for weight loss. Developing a diet plan by reducing calorie

intake, increasing physical activity, and adding behavioral counseling are important for a

successful weight loss plan. Individuals with a BMI greater than 30 or greater than 27 with other

comorbidities that do not have success in losing weight with diet and exercise may need to add

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