Ch. 48 PrepU

A nurse cares for a client who is post op from bariatric surgery. What risk factors does the nurse recognize increases the client's risk for developing venous thromboembolism (VTE)?

Age Higher BMI History of VTE

The nurse cares for clients with obesity and understands that causes are multifactorial. What factors contribute to the development of obesity?

Behavior Environment Physiology Genetics

The nurse cares for a client with obesity and discusses the increased risk of certain cancers related to obesity. Which cancers will the nurse include in the teaching?

Colorectal Breast Cervical

When discussing lifestyle modifications with a client who has obesity, what caloric deficit should the nurse recommend in order for the client to safely lose weight?

500-1000 calories

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 2-3 years postoperatively

A nurse cares for a client who is postoperative bariatric surgery and has experienced frequent episodes of dumping syndrome. The client now reports anorexia. What is the primary reason for the client's report of anorexia?

Fear of eating

An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true?

Diabetes mellitus is more common in Hispanics and Blacks than in Whites

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 researcher investigates why clients with obesity who have lost weight often regain the weight. The nurse looks at the relationship of leptin and its role in weight gain. What does the nurse determine is true regarding leptin and weight gain?

Drops in leptin level increases hunger Leptin signals satiety in the hypothalamus

A nurse caring for a client who is post op bariatric surgery notes that the client has no bowel sounds and suspects the client may have a bowel obstruction. What treatment or therapy does the nurse expect the client will require?

Endoscopy

A client who is postoperative bariatric surgery is diagnosed with bile reflux. Which conditions are associated with bile reflux?

Esophagitis Gastritis

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?

How to empty the drain Recording drainage amount When to contact the health care provider How to measure the drainage amount

Which of the following is a risk factor for the development of diabetes mellitus?

Hypertension Obesity Family history Age greater of 45 years or older History of gestational diabetes

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?

Hypertension, coronary artery disease, heart failure, myocardial infarction

A nurse cares for clients with obesity and recognizes that clients with larger waist-to-hip ratios are at greater risk for obesity-related morbidity in comparison to others with smaller waist-to-hip ratios. What findings related to this does the nurse recognize as true?

Individuals with larger waist-to-hip ratios are also referred to as apple-shaped Individuals with larger waist-to-hip ratios have larger visceral fat stores Individuals with larger waist-to-hip ratios have android obesity

A nurse is teaching a group of adults on the risks of obesity on neurological health. What statement will the nurse include in the teaching regarding obesity and the risk for developing Alzheimer disease?

Individuals with obesity are twice as likely to develop Alzheimer disease than those who do not have obesity

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 client has just received a diagnosis of hypertension after the completion of diagnostics. What can the client do to decrease the consequences of hypertension?

Lose weight Manage stress effectively

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 best promotes health in the client taking this medication?

Make sure and take a daily multivitamin

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 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 male client in a wheelchair comes in for his yearly physical examination. He is unable to stand. The nurse retrieves the wheelchair scale to obtain an accurate weight. The nurse understands the importance of this assessment with this client. What is the nurse's reasoning for obtaining an accurate weight?

People with disabilities have an increased incidence of obesity

A nurse cares for an obese client taking phentermine/topiramate-ER. Which laboratory findings will the nurse recognize as most concerning and will report to the health care provider?

Potassium 3.3 mEq/L Bicarbonate 19 mEq/L

A client with obesity is interested in trying orlistat for weight loss. Which disease or condition in the client's medical history alert the nurse of potential complications if the client uses this medication?

Renal insufficiency

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 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 client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?

Osteoarthritis

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 nurse cares for a client with obesity who takes anticonvulsant medication for the treatment of epilepsy. Which anticonvulsant medications may be contributing to the client's obesity?

Carbamazepine Gabapentin

A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching?

Nausea

The nurse cares for a client who is post op bariatric surgery whose bowel sounds have returned and is tolerating oral intake. What teaching will the nurse provide the client about the nutrition required at this time?

You need to drink plenty of water in between meals Eat slowly You will have six small meals per day

A nurse cares for an older adult client with obesity who also has glaucoma. Which obesity medication is contraindicated in this client?

Phentermine

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 working in a bariatric clinic assesses various clients with obesity. Which clients will the nurse recognize as meeting the selection criteria for bariatric surgery?

48-year-old female with BMI 36 k/m2 and uncontrolled type 2 diabetes 34-year-old male with BMI 30 k/m2 and metabolic syndrome with hypertension

A client who is post op from bariatric surgery tells the nurse, "I love cereal for breakfast. Do you have recommendations for which kind I should eat?" How should the nurse respond?

Choose a cereal with less than 2 grams of fiber per serving

A nurse cares for a client with sepsis who had bariatric surgery two weeks ago. What is the most likely source of the sepsis?

Disruption at the site of anastomosis

A nurse cares for a client with obesity who is scheduled to undergo vagal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include?

It is a pacemaker-type device that is implanted under your skin A pre-programmed pulsating signal is delivered Recharge the device two times per week

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 taking lorcaserin reports feeling agitated lately and has had diarrhea for several days. What is the nurse's priority response?

Notify the health care provider

A nurse is caring for a client who is post operative bariatric surgery. The client's pain has not been well controlled. Which nursing diagnosis is the nurse's priority?

Risk for impaired gas exchange

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?

Serotonin syndrome

A nurse examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true?

Those with less education are impacted at a greater prevalence of disease Those with less income are impacted at a greater prevalence of disease

Place the pathophysiology of obesity in the correct order.

Increased body fat Adiposopathy Release of biochemical mediators Chronic inflammation Disease

A nurse researches the cost and financial impact of obesity in America. What is the annual health care cost tied to obesity?

$147 billion

A nurse cares for a client with a BMI of 40 kg/m2. Which gastrointestinal condition or disease does the nurse recognize is associated with the client's BMI?

Colorectal cancer

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 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 geneticist is researching the gut microbiome and its relationship to disease. What is true regarding the microbiome?

It has over 100 times more genes than the human genome

A nurse prepares nutrition education for a client who will undergo bariatric surgery. What nutrition suggestion best indicates a beneficial effect on the number and quality of bowel movements the client may have after surgery?

Avoid high-fat foods

A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis?

Sweating, Tachycardia, Dizziness

A nurse researcher evaluates the epidemiology of obesity among gender and ethnicity of adults in the United States. Which findings correlate with data the nurse researcher finds?

Among women, the highest prevalence of obesity is among non-Hispanic blacks Among men, the highest prevalence of obesity is among hispanics.

The nurse is teaching a group of clients with obesity about the risks of disease associated with obesity. Which respiratory conditions or diseases will the nurse include in the teaching, which are associated with obesity?

Asthma Infection Obstructive sleep apnea

The nurse is teaching injection techniques for a client prescribed liraglutide for the treatment of obesity. Which areas of the body will the nurse suggest for injection sites?

Upper thigh Abdomen Upper arm Lower thigh

What pathophysiological concept is related to the increase in the hormone leptin, as it relates to satiety and hunger?

Increased adipose stores

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.

Increased adipose tissue Impairment of peripheral blood flow Blood stasis Formation of a thrombus

A nurse works in a community clinic that treats clients with obesity. The nurse understands that obesity is considered a disease based on what characteristics?

It impairs normal body function It has characteristic signs and symptoms It causes morbidity

At its most fundamental level, what does obesity result from?

A metabolic imbalance

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 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 nurse researcher analyzes data trends of obesity in both the United States and globally. What statistics does the nurse determine is true regarding the epidemiology of obesity?

Over 600 million adults have obesity worldwide The prevalence of obesity has more than doubled since 1975 The prevalence of obesity in the United States is the highest in the world

A client who is post op bariatric surgery reports diarrhea. What is the most likely cause of the client's symptoms?

Poor dietary choices

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