Critical Thinking Exercise No.

6 (Assessment and Management of Patients with Obesity)

1. You work as a staff nurse in a women’s health clinic. A 20-year-old woman presents to the clinic
for her annual screening physical examination and is requesting a prescription refill for “birth
control.” You note that her height is 64 in and she weighs 163 lb. You note on her electronic
health record that she weighed 152 lb last year. What is her BMI? She says to you “I would really
like to lose some weight before I go on my vacation in 6 weeks. What diet do you think will help
me to quickly lose the most weight?” Describe what other information you may gather from her
that might help guide her to a healthier lifestyle. What is the strength of the evidence suggesting
that any given commercial or other diet plan may offer her the healthiest weight loss outcomes?
Questions Answer
a) What is her BMI? Conversion: BMI calculation:
163lb / 2.2 = 74.09kg 74.09kg / (1.6)2 = 29.9kg/m2
64 in * 0.0254 = 1.6m
The patient’s BMI is 29.9kg/m2
which fall under overweight
classification.
b) What diet do you think  Waist circumference and hip measurements are the factors
will help me to quickly that can be assessed in order to determine the appropriate
lose the most weight?” diet plan of the patient. In addition, laboratory tests may
Describe what other done in order to determine the patient’s level of cholesterol,
information you may triglycerides, fasting blood suger, glycosylated hemoglobin,
gather from her that aspartate aminotransferase, and alanine aminotransferase
might help guide her to a can be conducted in order to create an appropriate diet and
healthier lifestyle. exercise plan for the individual. Moreover, an adequate diet
with moderate exercise helps in maintaining a healthy
weight.
c) What is the strength of  According to Katz, David L. and Suzzane Meller, following
the evidence suggesting a popular diet regime is not always necessary to lose
that any given weight. However, cutting down the intake of trans fat
commercial or other diet (unhealthy fats), sugar, and processed food products
plan may offer her the and plant-based food products can be helpful.
healthiest weight loss
outcomes?
2. A 51-year-old male patient is just over 24 hours post coronary artery bypass graft surgery and is
a patient on your progressive care unit. You note on his electronic health record that his BMI is 42
kg/m2. His BP is 124/72 mmHg, HR 112 bpm, RR 22 breaths/min, T 100.9°F and his SpO2 is
90%. Describe your priority nursing assessments for this patient. What nursing interventions
would you implement first?
Questions Answer
a) Describe your priority  Assessment of airway patency
nursing assessments for a. Maintenance of airway patency
this patient. What nursing b. Provide Oxygen as prescribed
interventions would you c. Decrease patient’s level of anxiety
implement first?  Monitor v/s
 Evaluation of cardiac status
3. Your friend’s mother is 9 months post bariatric surgery. She tells you that she is doing well and
has been successful in reaching her weight loss goal. She says she does not feel the need to
follow up with her nutritional counselor, primary provider, or support group, as she is “handling it
 on her own.” What reasons would you give her for continuing with these follow-up
appointments? On what evidence do you base your answer?
Questions Answer
 What reasons would you  The patient is at risk of developing malnutrition - follow up
give her for continuing with procedure must be continued to prevent malnutrition.
these follow-up  The patient is at risk of becoming overweight - follow-up
appointments? On what procedure must be continued in order to properly manage the
evidence do you base your patient’s weight.
answer?  The patient must have a proper medical supervision in
order to avoid complication. A study conducted by Society
for metabolic and Bariatric Surgery of Country, the
individual must get medical attention for the rest of their
life, follow a proper and nutritious diet plan, and develop
normal bowel practices.