Chapter 48: Assessment and Management of Patients with Obesity
32.7
A client weighs 215 lbs and is 5' 8" tall. The nurse would calculate this client's body mass index (BMI) as which of the following?
Rapid gastric dumping
A client who is postoperative from bariatric surgery reports foul-smelling, fatty stools. What is the nurse's understanding of the primary reason for this finding?
Osteoarthritis
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?
acute cholecystitis
A middle-aged obese female presents to the ED with severe radiating right-sided flank pain, nausea, vomiting, and fever. A likely cause of these symptoms is:
Bupropion
A nurse cares for a client with obesity who is also diagnosed with depression. Which medication does the nurse expect the health care provider will prescribe, which also aids in weight loss?
"You should avoid pregnancy for at least 18 months after surgery."
A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?
Both undernutrition and obesity
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face?
"It causes delayed gastric emptying."
A nurse reviews with the client the various types of medications used to treat diabetes. Which statement will the nurse use when teaching the client about liraglutide's mechanism of action?
Heart failure Hypertension Coronary artery disease Myocardial infarction
A nurse working in a cardiac health care office notes increased risk of certain cardiac conditions as a result of obesity. Which conditions can be associated with obesity? Select all that apply.
Has a weight gain of 5 pounds
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
Class I obesity
A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI?
Degenerative joint disease
A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?
"The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use?
"You have succeeded in making positive progress."
A client who is obese and the nurse have established a goal for the client to achieve a weight loss of 1 pound each week. One month later, the nurse evaluates that the client has lost 2 pounds. The nurse first states
Age
A client with newly diagnosed hypertension asks what she can do to decrease the risk for related cardiovascular problems. Which of the following risk factors is not modifiable by the client?
Serotonin syndrome
A client with obesity has been taking lorcaserin for several months and presents to the health care provider's office reporting fever and diarrhea. Which life-threatening condition does the nurse suspect?
Metformin
A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering?
"This is an expected finding with this medication."
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?
Cushing's disease
A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?
"It binds with enzymes to help prevent digestion of fat."
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include?
Low Fowler's
A nurse cares for a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?
Stimulate GI peristalsis
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?
"Do not drink alcohol while taking this medication."
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication?
Phentermine
A nurse cares for an older adult client with obesity who also has glaucoma. Which obesity medication is contraindicated in this client?
Weight BMI Waist circumference
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.
There is a 6-20 year decrease in overall life expectancy for those with obesity.
A nurse epidemiologist examines the overall decrease in life expectancy related to obesity. What finding is true?
It has over 100 times more genes than the human genome.
A nurse geneticist is researching the gut microbiome and its relationship to disease. What is true regarding the microbiome?
"I should become involved in a weight loss program."
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
Obesity Tobacco use Hyperlipidemia
A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.
Manual compression and prophylactic anticoagulation
A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate?
Obesity along with conditions associated with it has become a major health concern.
A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns?
"Avoid taking non-steroidal anti-inflammatory drugs."
A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers?
23
A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk?
"Older adults have a greater prevalence of obesity in comparison to the general population."
A nurse prepares community teaching on healthy lifestyle modifications to a group of older adults. When discussing obesity rates of older adults in comparison with the rest of the population, what will the nurse include?
Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true?
transesophageal echocardiography
An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed?
All options are correct.
An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer?
100
Morbid obesity is defined as being how many pounds over the person's ideal body weight?
increased adipose tissue Impairment of peripheral blood flow Blood stasis Formation of a thrombus
Place the pathophysiological steps in order of how a client with obesity is at greater risk for venous thromboembolism in comparison to the general population.
Behavior Environment Physiology Genetics
The nurse cares for clients with obesity and understands that causes are multifactorial. What factors contribute to the development of obesity? Select all that apply.
includes an incremental goal of 1-2 pound weight loss this week
The nurse establishes a learning contract with an overweight client. The contract is best if it
The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
A BMI >40 kg/m2
What statement best describes a client with severe or extreme obesity?
Wound dehiscence
You are caring for a client who is an obese diabetic. The client is 48 hours post surgery. What is this client at increased risk for?
"The fat is passed in your stools."
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?