Obesity Case study PDF

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Summary

Case study on patient with obesity. Goes over a patient that comes in with signs and symptoms of obesity. Student must explain the pathophysiology of the disease and patient management....

Description

Obesity Case Study Larry is a 36-year-old male who is at the health clinic requesting possible bariatric surgery due to obesity. He reports he has always been heavy along with all of his family members. He states he has gained 100 lobs in the last 3 years. He works as a computer programmer. SUBJECTIVE DATA: •

Says he is constantly dieting but he gives up and eventually eats to satisfy his appetite

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Admits to being treated for depression

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Lives alone in an apartment and has several good friends but rarely socializes due to his size

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He has difficulty sleeping and at times feels short of breath with chest pains

OBJECTIVE DATA: •

Height: 68 inches (5’8”); Weight: 300 lbs.

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Vitals: BP 172/96; P 90; RR 24; pox 97%

1. What medical problems is Larry at risk for developing? Due to his morbid obesity Larry is at risk for developing a wide range of issues. Larry could be at risk for TII DM, obesity hypoventilation syndrome, sleep apnea, asthma, HTN, metabolic syndrome, hypogonadism, gynecomastia, osteoarthritis, gout, sexual dysfunction, lumbar disk disease, GERD, and gallbladder cancer.

2. What diagnostic tests would you want to use to evaluate Larry’s current state of health? Fasting glucose test and thyroid function test should be ordered to rule out other causes. A lipid panel and liver function test will be needed to evaluate the effects.

Diagnostic Test Findings: EKG: NSR with slight nonspecific ST changes CXR: Clear lungs, enlarged heart noted Fasting blood glucose: 146 mg/dL Total cholesterol: 250 mg/dL; Triglycerides: 312 mg/dL Potassium: 3.6; BUN/Creat: 20/1.6 3. What are your priorities for patient education? The patient needs to understand his health status and medical condition and the risks and limits associated with it. He needs to be aware of the urgent diet changes that need to be implemented immediate in order to preserve his health. The patient will need proper diet teaching and exercise plan.

4. What options are available for Larry? Larry has the option to make alterations in his lifestyle choices involving diet and exercise, management through medication, or become a candidate for bariatric surgery if all the criteria is met.

5. What other healthcare providers might you involve in Larry’s care? A nurse can provide diet teaching and exercises strategies however, for this specific case a dietician would be useful to provide Larry with the information he needs to successfully implement diet changes. A physical therapist may also provide Larry with extra support on how he can exercise safely and effectively. 6. Before selecting a weight reduction plan with an obese patient, what is most important for the nurse to first assess? A. The patient’s motivation to lose weight. B. The length of time that the patient has been obese. C. Whether financial considerations will affect the patient’s choices. D. The patient’s measurements including height, weight, BMI, waist to hip ratio and skinfold thickness. 7. Which explanation about weight reduction should be included when teaching the obese patient and her obese husband? A. Weight gain is caused by psychologic factors. B. Daily weighing is recommended to monitor weight loss. C. Fat is not burned until the glycogen-water pool is depleted. D. Men lose weight less quickly than women because they have a higher percentage of metabolically less active fat. 8. In developing a weight reduction program with a 45-year-old female patient who weighs 197 lb., the nurse encourages the patient to set a weight loss goal of how many pounds in 4 weeks? A. 1-2 B. 3-5 C. 4-8 D. 5-10 9. The nurse has discussed reasonable weight loss goals and a low-calorie diet with an obese patient. Which statement made by the patient indicates a need for further teaching? A. "I will limit intake to 500 calories a day."

B. "I will try to eat very slowly during mealtimes." C. "I'll try to pick foods from all of the basic food groups." D. "It's important for me to begin a regular exercise program."...