prepU ch 48 Assessment and Management of Patients with Obesity
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?
"Avoid taking non-steroidal anti-inflammatory drugs."
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?
"Do not drink alcohol while taking this medication."
A nurse cares for a client who wants to know more information about bariatric surgery. The client asks the nurse, "What weight loss can I expect?" What is the nurse's best response?
"Expect to lose 10-35% of total body weight 2 to 3 years postoperatively."
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
"I should become involved in a weight loss program."
A nurse is caring for a client who will undergo bariatric surgery. Which nutritional recommendation will the nurse include in the client teaching?
"Increase your intake of plant-based proteins."
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?
"It binds with enzymes to help prevent digestion of fat."
A nurse reviews a client's medication list and notes the client takes orlistat for the treatment of obesity and to promote weight loss. Which client teaching will the nurse include that bestpromotes health in the client taking this medication?
"Make sure and take a daily multivitamin."
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?
"Older adults have a slightly higher prevalence of obesity in comparison to the general population."
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?
"This is an expected finding with this medication."
A client who is 6 months postoperative bariatric surgery tells the nurse, "I hate what my body looks like now. All these skin folds really bother me." What is the nurse's best response?
"You are not alone in having these feelings."
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
"You have succeeded in making positive progress."
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?
"You should avoid pregnancy for at least 18 months after surgery."
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?
23
A client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what?
32.7
A nurse caring for adults with obesity recognizes that obesity is classified based on BMI. Which BMI does the nurse recognize as Class II obesity?
35 kg/m2
What statement best describes a client with severe or extreme obesity?
A BMI >40 kg/m2
The charge nurse was discussing with the nursing student that studies have been published that suggest inflammation increases the risk of heart disease. Which modifiable factor would the nursing student target in teaching clients about prevention of inflammation that can lead to atherosclerosis?
Addressing obesity
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
Age
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?
All options are correct.
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?
Both undernutrition and obesity
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?
Bupropion
A nurse is planning care for a client who will undergo bariatric surgery in a week. What goals are acceptable during this point in the client's care? Select all that apply.
Client will become knowledgeable about the procedure. Client will understand preoperative and postoperative dietary restrictions. Client will have decreased anxiety about the procedure.
The nurse is working with a client who has difficulty controlling blood sugar. The client is classified as overweight. The client does not adhere to a low-calorie diet and forgets to take medications and check blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, what action will the take first?
Collaborates with the client to establish an agreed-upon goal
The nurse plans care for a client with obesity. What does the nurse recognize is the primary pathophysiological reason clients with obesity are at greater risk for developing thromboembolism?
Compromised peripheral blood flow
A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis? Select all that apply.
Dizziness Sweating Tachycardia
A client who is postoperative open RYGB bariatric surgery is scheduled for discharge and will have a Jackson-Pratt drain to care for while at home. Which teaching will the nurse include specific to this? Select all that apply.
How to empty the drain How to measure the drainage amount Recording drainage amount When to contact the health care provider
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.
Hyperlipidemia Obesity Tobacco use
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.
Hypertension Coronary artery disease Heart failure Myocardial infarction
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?
Mechanical compression and prophylactic anticoagulation
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?
Metformin
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?
Osteoarthritis
A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity?
Over time, we have become efficient in food storage and deposition of fat stores.
A nurse cares for a client with obesity who reports taking "a medication of weight loss" but cannot remember the name of it. The client also reports nervousness and feeling "jittery". Which medication is the client most likely taking?
Phentermine
A nurse teaches a client with obesity about the various medication options for the treatment of obesity. Which medication will the nurse include when teaching the client about the class of medications that stimulate noradrenergic receptors?
Phentermine
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?
Rapid gastric dumping
A nurse works in a bariatric clinic and cares for client with obesity who will or have undergone bariatric surgery. What is the nurse's understanding of how the procedure works?
Restricts the client's ability to eat.
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?
Stimulate GI peristalsis
The nurse observes that a client's medical report indicates that the client has Cushing syndrome. During inspection, the nurse notes that the client's BMI is 31, waist circumference is 40 inches, and localized fat pads exist around the neck and upper part of the back. Which of the following must the nurse keep in mind while planning the client's care?
The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
A nurse epidemiologist examines the overall decrease in life expectancy related to obesity. What finding is true?
There is a 6-20 year decrease in overall life expectancy for those with obesity.
A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage?
These are less likely to cause dumping syndrome.
A nurse cares for an obese client who wants more information about naltrexone/bupropion to help with weight loss. Which medical conditions does the nurse recognize as contraindications to this medication? Select all that apply.
Uncontrolled hypertension History of alcohol abuse History of bulimia Epilepsy
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.
Weight BMI Waist circumference
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for?
Wound dehiscence
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:
acute cholecystitis