Introduction
Pregnancy is a momentous event in a woman’s life. However, it can also be overwhelming because of the changes that is undergoing through a woman’s body that generally involves a significant amount of hormonal changes. Given all these physical, physiological and emotional changes, it is natural that a pregnant woman could experience significant amount of sensations and discomforts. One of the causes of this discomfort is the increase in weight that a pregnant woman has to put up because of increased appetite and the additional mass associated with the growing fetus. However, there are instances when the weight gain becomes uncontrolled and it leads to other secondary discomfort like back pains, emotional issues relating to body dysmorphic disorder which is among others. Obesity is also identified as one of the major causes of pain aggravated during pregnancy.
Obesity is becoming one of the biggest problems that the world is experiencing today. More and more people are being diagnosed as obese, which largest affects not only the health and wellness statistics of a nation but it also contributes to economic productivity particularly when a large number of its workforce is being classified as chronically obese. In this regard, an important initiative of the government and several institutions is to identify the causes of obesity and address how this can be rectified. As a result, this paper aims to conduct a study that would take one of the most influential social institutions in the country and map out the progress of obesity in this industry. In addition, this paper also aims to construct an analysis of the behavioral diagnosis of obesity among individuals according to their professional demarcation and age bracket, in this case campus staff between the ages of 30 to 50 years old.
Obesity is one of the leading global health concerns identified by the World Health Organization . In fact, in 2008 1.4 billion people from all across the world had been classified as overweight, 500 million were obese . The proportions were overwhelming, even proving that there were more obese women than men on a 2:1 proportion. These figures had only been limited to adults, still not including the youths. In 2011, an alarming statistics revealed that 40 million children below age five were already classified as obese .
Amidst the growing problem on obesity, it has been found that this condition is highly preventable. In fact, several researches reveal that among the major causes of obesity could be addressed through behavioral modification . Given this understanding, among the first necessary step to undertake in addressing this condition is a thorough behavioral diagnosis of the patient.
Behavioral diagnosis is defined as the procedure of trying to identify the behavioral signs and symptoms of a medical condition through history taking, physical and neurological tests and diagnostics which can overrule any possibility of another medical condition . In the case of this study, this paper hopes to determine and identify the root of obesity among campus staff that age fell under the bracket of 30 to 50 years. To accomplish the objectives set forth in this study, the author of this paper would conduct an extensive review of literature, which seeks to identify the factors leading to the incidence of obesity especially within the context of the professional classification and age demarcation proposed in this study. In addition, the author of this paper will also include in this discussion any literature, which may suggests that obesity is a behavioral problem, which requires behavioral treatment.
Pathophysiology
A dictionary definition of the term obesity according to a medical dictionary is the presence of excessive body fats . However, being excessively overweight also means that there is too much body weight over as what is appropriate for one’s height . On this light, overweight might be due to several different factors like muscle, bones and water content in an individual’s body. Non-physiologic factors of obesity might be caused by poor lifestyle.
This paper hopes to device a mechanism, which would motivate participants, classified as obese to alter their behavioral patterns to achieve a goal demarcation of attaining the average BMI decrease of 25% by 2015.
In a study conducted several years ago, there was enough evidence to suggest that the reason for the blowing up of the population has been because of the poor lifestyle that people are most inclined of living . In the said study, the author attributed the sedentary lifestyle of the Americans as the major culprit to this the current problem on obesity. Shute said that aside from the fact that people were actually eating more these days they are also unable to burn these fats because majority does not engage in physical activities. Going back, the types of food that people are indulging are not nutritious foods, rather they are foods that high are cholesterol and exceeds the daily calorie requirement of an individual.
On the other hand, statistics proved that more women are in fact heavier than man. This is because women are more prone to binge when experiencing stress and other emotional discomfort . Due to this binging, women gains weight and their eating pattern becomes uncontrollable. Women are also less active in engaging in physical activities as compared to their male counterparts. Thus, fats are rarely burned after being consumed.
The Center of Disease and Prevention provided several preventive measures to control the ill effects of obesity among the individuals. Among these recommendations, include adapting a healthy lifestyle habit . Specifically, the group recommends that individuals should start eating healthy and start participating in physical activities that would help burn down the calories they’ve consumed.
The organization also capitalized on the importance of a support group system in helping the patient reduce weight. The motivation would not only be limited to the patient’s family but also the school, peers, the government and the society in general. To be specific, the CDCP said that the school has an important role to play in the quest to maintain the campuses’ staffs’ weight because these sector spend most of their time at school than anywhere else. Therefore, the school should create programs that would encourage their employees to live healthy.
After due deliberation of these findings, the author hereby suggest the urgent need for behavior modification. By behavioral modification, the authors establish that every obese faculty staff should alter their eating habits. Instead of binging, individuals should eat square meals composed of foods that have low carbohydrates. Eating should not be held as an outlet for emotional stress.
In addition, it is also hereby suggested that people participate in physical activities that would aid in burning down the excess fats and calories in the body. The sedentary lifestyle of faculty staffs that is best represented by staying in their seats when conducting lectures. Instead of being confined in their seats, the participant should consider being mobile or moving from within the confine the classrooms.
Behavioral Objectives
This study hopes to achieve the following objective:
Attain a 25% in average BMI across campus community faculty staff by 2015
Modify the sedentary lifestyle of the faculty by fostering a dynamic classroom interaction instead of the traditional lecture type discussions
Modify the eating habits of the participants by eliminating the binging habits among faculty members
Part 1
Causes and Management Interventions of Discomfort and Pain during Pregnancy, Labor, Birth, and Recovery from Birth
As mentioned earlier, there can be a lot of conditions that may affect an individual’s level of comfort at any point during the entire length of pregnancy, be it as a prenatal or a neonatal. In this part of the paper, however, we will only focus on two of the most common conditions that cause pain and or discomfort for the antepartum, intrapartum, or postpartum patient in an uncomplicated pregnancy. A brief discussion of the different pharmacologic and rehabilitative management procedures to address such condition or source of discomfort will also be included.
Preeclampsia and Eclampsia
- Identify and Explain two sources of pain for a pregnant patient
If there is one serious medical condition that a pregnant woman at any point during his entire length of pregnancy can and should strive to avoid, that will be this pair of condition, preeclampsia or what is also known as toxemia. Preeclampsia is a condition that only pregnant women develop that is characterized by considerable and often detrimental leaps in blood pressure. Preeclampsia is the early and milder form of eclampsia. Eclampsia, on the other hand, is more severe because it can potentially lead to the death of the fetus and the mother. If they are lucky, at least one of the two may survive.
There are, however, a significant number of cases of mother and child birth as a result of the complications of the later form of this pregnancy-related medical condition. Aside from the marked increase in blood pressure, another testing procedure that may improve the reliability of diagnosing the condition would be a comprehensive urine analysis and an assessment of signs and symptoms of the condition during physical examination. In the urine analysis, for example, one finding that may indicate the presence of preeclampsia or in its later stages, eclampsia (preeclampsia is considered as the milder and early form of eclampsia), is an increase in the level of proteins in the urine sample.
It is important to note, however, that these two major findings during pregnancy (increased blood pressure and urine protein levels) should be carefully analyzed for differential diagnosis because there are simply a lot of other conditions that may be misdiagnosed as eclampsia or preeclampsia. Other clinically relevant information that may help a medical health professional working with pregnant women determine whether one or more than one of their prenatal patients are exhibiting signs and symptoms of this condition include, significant swelling in the distal extremities (i.e. feet, hands, legs), occurring at any time during the second half of pregnancy or a little bit earlier.
The exact nature of the disease is still largely unknown. In fact, much of the available information about the condition is still debatable. A good example would be the causes and pathophysiology of preeclampsia and eclampsia. It is not yet fully clear to the academic and clinical practitioners’ community what serves as the trigger to these two conditions.
There are academic journals that suggest that it comes as a result of a placenta that is not functioning properly; there are sources that suggest that poor nutrition is the root cause; and there are also studies that point to more specific health issues such as high levels of body fat, abnormally low levels of blood flow to vital areas within the uterus, and even genetics as the root causes of preeclampsia and eclampsia.
- Identify pain management measures for the patient. Explain the benefits and risks of each measure.
Given the nature of the disease, there is no drug that can effectively treat preeclampsia or eclampsia. The general advice to pregnant mother who have exhibited even just early signs and symptoms of the disease is for them to deliver their baby the soonest time that it has developed enough, often after reaching the 37-week mark or later. In some cases or in those wherein the baby has not yet developed enough for it to be delivered and the mother is not exhibiting severe signs and symptoms of the medical condition, patients may be advised to undergo observation with bed rest and anti-hypertensive drugs .
The benefit of the earliest delivery measure is it immediately takes the mother and the baby out of danger. Because the baby is already out, the mother can already take medications that she could not take when she was pregnant and address the hypertension, which is the root cause of majority of the complications of eclampsia or preeclampsia.
Physicians have to make sure, however, that the baby is indeed ready for delivery before they choose the first option. The risk involved in the second option is the risk that the patient’s condition would deteriorate and lead to advanced eclampsia which, as mentioned earlier, puts both the baby and the mother in a very dangerous situation. Because of this, careful monitoring of the urine protein levels and of course, the blood pressure of the mother, has to be done.
Part 2
- Identify Three Variables Unique to the Pregnant Patient that need to be considered when developing a patient specific pain management teaching plan with an explanation why these variables need to be considered when developing a teaching plan.
It is important to note that the best way to fight preeclampsia and its usually more severe counterpart on the later stages of pregnancy is to prevent it, and the most important variable to consider to prevent an individual from contracting any form of medical condition or disease are the risk factors. In this case, as in the case of other medical conditions, there are modifiable and non-modifiable risk factors. Unfortunately, medical professionals can only make significant changes on an individual’s chance of suffering from the condition by focusing the modifiable risk factors because as the name implies, they are modifiable. In preeclampsia and eclampsia, the risk factors are mostly non-modifiable.
Individuals who score four out of the five major risk factors of the disease are often advised to seek the advice of a medical specialist in order to prevent future pregnancy-related complications. A history of recurrent acute bouts of hypertension prior to pregnancy; a history of preeclampsia (for mothers who have been pregnant before); being overweight or obese or a history of hyperlipidemia; carrying more than one baby during a single pregnancy (i.e. twins); a family history of preeclampsia or eclampsia; and a previous history of controlled or uncontrolled metabolic and arthritic diseases such as diabetes mellitus, rheumatoid arthritis, or systemic lupus erythematous .
If the patients are already manifesting a number of pre-eclampsia-related signs and symptoms, it would be smart to start looking out for eclampsia-related symptoms already because after all, that is the direction that the patient is most likely to go. Clinical signs and symptoms of eclampsia include pain in the abdomen, nausea, vomiting, dizziness, abnormal change in muscle reflexes, and edema on the distal extremities, unexplained weight gain, visual changes, headaches, and urinary incontinence.
Patients who have been diagnosed with either preeclampsia or eclampsia are generally advised to seek immediate medical attention if they find themselves having at least one of the following clinical signs and symptoms because they are indicative of an acute attack of eclampsia: severe swelling in the distal extremities, including the eyes and face; blood pressure that is consistently greater than 140/90 mmHg; severe headaches with intolerable pain levels; blurred vision with flashing lights and dizziness. All of these can be considered important because they can spell the difference between the death and life of the mother and her baby.
- Non-pharmacologic pain relief options in the intrapartum period with explanation.
As mentioned earlier, given the nature of the two pregnancy-related medical conditions we have discussed, there are no currently known pharmacologic options that can be used to address the main problem. Even so, that would prove to be risky for the mother and baby because pregnant mothers are often not allowed to simply take medications unless otherwise specified and guaranteed by the prescribing physician. Non-pharmacologic options for these two related medical conditions often include early delivery and putting the patient under a strict observation period until the symptoms subside.
For the first option or the early delivery option, three things have to be remembered. Firstly, it is only done if the physicians are already certain that the baby is already fully developed inside the womb because otherwise, this first option would be impossible. Secondly, it is often recommended for patients who are already exhibiting the more serious signs of preeclampsia or worse, eclampsia. Thirdly, patients who want to put themselves and their babies out of the danger zone may also choose this option provided that they fit the doctors’ criteria for early delivery.
For the second non-pharmacologic option or the close monitoring option, there are three things that the attending medical professionals have to remember. Firstly, the patient’s blood pressure should be carefully monitored. Ideally, the patient’s BP should be kept below 140/90 mmHg at all times because anything higher already exposes the patient and her baby to the risks and complications of preeclampsia. Secondly, urine protein levels should also be closely monitored while the patient is in bed rest so that the medical team can know whether the patient’s preeclampsia is advancing or if the patient is already recovering. And lastly, the patient should be educated on the things she should do to control her blood pressures and these things include, not eating a lot of fatty and unhealthy foods, controlling one’s diet, maintaining a healthy weight for pregnancy, and using joint protection and energy conservation measures.
References
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