Nurse’s Role in Taking Care of Obese Children Essay

Childhood Obesity and the Professional Nurse’s Role

In recent years, many scientists and doctors around the world became concerned about the problem of childhood obesity because it is a growing threat to the health of the younger generation. Notably, there is a variety of factors of childhood obesity which point to the roots of the problem. Thus, a nurse’s role in taking care of obese children is pivotal since obesity needs long-term treatment.

The Problem of Childhood Obesity in the USA

The problem of childhood obesity has recently become a major concern of pediatricians in all parts of the developed world. Modern children exercise less though they eat a lot of high-calorie foods. This leads to fat deposition and, as a result, body weight increases due to adipose tissue. Adipose tissue can be concentrated in places of physiological deposits, breasts, thighs, etc. It can be a catalyst for different health problems and a variety of psychological issues. Childhood obesity may cause diabetes, hypertension, depression, complexes, insecurity and other disorders associated with being overweight.

Statistics on obesity are different in many countries. However, data on childhood obesity in the United States accurately reflect the actual situation. According to official statistics, 68% of the US population suffer from excess weight. Over the past 15 years, the number of obese children has increased threefold. Thus, many pediatricians suggest the existence of serious health problem. In America, every second child is obese. 17% of children older than two years are obese. It should be noted that every fourth child is diagnosed with metabolic syndrome while every fifth young person has arterial hypertension. In addition, 17% of children suffer from the diseases of the thyroid gland whereas 6% have chronic gastroduodenitis (World Health Organization). 40% of overweight children are diagnosed with non-alcoholic fatty liver disease. Thus, statistics confirm that obesity in children is a health problem which needs immediate treatment.

Physical, Social, and Psychological Factors that Cause Childhood Obesity

Nowadays, the number of obese children is much higher than it was 10 years ago. Doctors associate the reason for this change with numerous physical, social, and psychological factors. Physical factors include early transition from breastfeeding to the usage of breast-milk substitutes, hereditary predisposition, endocrine diseases where fat formation prevails over its consumption, hypothyroidism (decreased thyroid function), hypogonadism, and various lesions of the hypothalamus that controls endocrine glands. Trauma obtained during childbearing, prolonged maternity, infection, and other issues are the main reasons for damaging the hypothalamus.

However, physiological factors do not have enormous impact on childhood obesity compared to psychological ones. At the same time, various psychological factors contribute to the development of physiological causes of obesity. For example, a child may be forced to eat more and move less. Psychological factors are internal. They include depressive perception of reality which results in the uncontrolled consumption of food that makes the world brighter, getting considerable pleasure from taking food, which turns into lust, and psychological dependence. The most crucial psychological factor is the formation of irregular eating habits. It includes feeding in a reluctant manner and others (European Union).
Social factors are mostly external. They include peers rejection because of the problems with appearance, the cult of food in the family, etc. The cult of food as well as frequent and uncontrolled feeding of children makes them obese. The major social factor is the presentation of food as a reward or encouragement. For example, the mother’s words: “If you behave well, I will give you a candy” subsequently lead to emotional eating.

Physical, Social, and Psychological Consequences of Obesity in Children

Children and teenagers suffer serious consequences caused by obesity. Physical issues include tendency to high blood pressure and gallbladder disease, especially the formation of gallstones, distinct defects in the motor system, flat feet, X-looked legs, hunched back, hyperlordosis, weak abdominal muscles and others. In addition, obese children often get short term rash, eczema, different injuries and burns (due to the fact that they are less mobile), inflammation of the airways, and constipation. What is more, boys may have delayed sexual development while girls experience menstrual irregularities. Nevertheless, with normalization of body weight, most of these problems can be avoided.

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Psychological consequences are all long term and include less autonomy and assertiveness, greater reliance on family, emotional immaturity as well as lack of strong will to adhere to the weight loss regime. It should be noted that parents usually provide background for these consequences. As a matter of fact, an obese child is the only child in the family or he/she is from a single-parent family, where he/she becomes the subject of increased concerns. Such children are less hardened, and they pay much attention to their malaise.
Social consequences include peer rejection in the school and long term inability to build social relationships. Obesity before puberty does not harm children’s social interaction. At puberty, obese children begin to experience various difficulties in social life. In case of depression or adverse situation, 75% of obese children seek solace in food while only 9% of children with normal weight do it (European Union). Obese teenagers feel their difference from other children. As a result, it is difficult for them to tolerate. They suffer from an inferiority complex, avoid companies, dancing and sports. Thus, physical effects can be both short and long term whereas social and psychological ones are mainly long term. Therefore, the urgency of providing professional help to obese children is obvious.

Teaching Plan for a Professional Nurse

For the selection of the optimal therapy and treatment of obesity, a nurse needs to consider all the factors and causes of its development. In case obesity is chronic, treatment should not be short term; it should be permanent. One of the features of proper treatment of obesity is a systematic decrease in the initial body weight by 5-10%. Gradual weight loss can not only reduce obesity but also combat the number of diseases that adversely affect the health of a child. At the same time, the professional nurse’s role in the process of treatment of obese child is difficult to overestimate.

It is highlighted in the teaching plan for a nurse. The plan includes the following positions:

1. General care issues and the theory of obesity:

  • The significance of nursing for the obese children.
  • Organization of nosotrophy.
  • Deontological aspects of childhood obesity treatment (professional duties of a nurse, scope of his/her activities, morality of nurse’s actions).
  • Physiological, psychological, and social aspects of obesity.
  • Etiology (alimentary, endocrine, and cerebral reasons behind obesity).
  • Predisposing factors of obesity (sedentary lifestyle, increased activity of the enzymes of lipogenesis, decreased enzyme activity of lipolysis, increased intake of digestible carbohydrates, endocrine disease, susceptibility to stress, lack of sleep, usage of psychotropic drugs, etc.). The pathogenesis of obesity does not depend on its cause. Excessive consumption of food high in carbohydrates causes hyperinsulinism. Hypoglycemia makes a child feel hungry. Insulin is the principal lipogenetic hormone, which has anabolic effects and influences the synthesis of triglycerides in adipose tissue.
  • The clinical picture of an obese child (diagnosis of diseases associated with obesity).
  • The classification of obesity, anamnesis (a) exogenous constitutional obesity (primary, alimentary and constitutive): gynoid (gluteal-femoral, bottom type), and android (abdominal, visceral, upper class). (b) Secondary obesity (with a genetic defect (including some genetic syndromes with multiple organ lesions)); cerebral (hypophyseal syndrome, systemic dissemination of lesions, infectious diseases, endocrine disorders (hypothalamic disease, pituitary, adrenal disease), and iatrogenic diseases (caused by taking certain drugs).

2. Medical institution and organization of its work:

The main types of health care institutions.
The organization of in-patient facility and reception.
Sanitization and transportation of obese children.
Organization of therapeutic department.
Sanitary schedule and its value.

3. Taking care of personal hygiene of obese children:

The positioning of a patient, tilting bed equipment.
Preparation of the sickbed. Change of bed sheets and underwear.
Tackling urine incontinence.
External hygiene, skin/hair care, etc.

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4. Nutrition of obese children. Dietetics:

Basic principles of clinical nutrition of obese child.
Organization of the nutrition, psychological impact of dietetics.
Creation of a negative energy balance. Females should reduce calorie intake by 500-1200 kcal per day while males should lower it by 1500 kcal per day. This lack of energy will provide weight loss of 0.5-1 kg per week. The amount of protein can be increased, comparing with physiological norms, to 1.5 g/kg of ideal body weight, which is important for maintaining the activity of the enzyme in lipolysis and prevention of fatty liver. A nurse should control a diet: a patient has to consume proteins of animal origin and eat enough vegetables.
Artificial nutrition.

5. Observation of the obese febrile patients:

Measurement of body temperature, the usage of thermometers.
Fever, its types.
Features of care of febrile obese children.
Methods of influence on blood circulation: compresses, physiotherapy, hydrotherapy, etc.

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6. Treatment of obesity:

6.1. Non-drug methods (diet therapy, increasing physical activity – short-term activity ensures consumption of liver glycogen and long-term activity guarantees the involvement of fat stores).

6.2. Drug methods.
Prescription, storage and administration of medicine to obese children.
Methods of drug administration and injections.
Complications after injections and their prevention.
Other features of observation of children suffering from obesity.

6.3. Surgical methods (gastric bypass, gastric banding, local liposuction, etc. The latter method is promoted by beauticians and regarded as a one-stage decision. However, the weight lost as a result of liposuction is restored in case of absence of lifestyle change. Therefore, such a procedure does not have a strategic value.).

7. Sequels, preventive measures.

Metabolic syndrome, gastroesophageal reflux disease, diabetes of 2 type, coronary heart disease, myocardial infarction, stroke, hypertension, chronic venous insufficiency, cholecystitis, cholelithiasis, hernias, cancers and osteoarthritis can be caused by obesity. Primary and secondary preventive measures should be taken. At the same time, the role of nurses in the implementation of preventive measures is vital.

  • The first step is the following: parents need to understand the importance of proper nutrition and a healthy lifestyle. A nurse needs to educate the child about adequate dietary habits and organize his/her regime in an appropriate manner (Centers for Disease Control and Prevention, n.d.).
  • The second step of nurse is to help a child develop an interest in physical culture and sports. The nurse can motivate parents to set an example of a healthy lifestyle.

Childhood obesity is a serious problem in the American society. The significance of professional nurse’s role in the process of treatment of obese children is also confirmed with statistics. The analysis of genetics, formation of abnormal eating habits along with the promotion of food emphasizes the necessity of providing obese children with professional help to avoid different problems in the future.

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