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Nursing care of the morbidly obese patient

doi: 10.1097/01.NME.0000316728.99731.a9

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GENERAL PURPOSE: To provide the professional nurse with information to enable provision of competent and compassionate care to morbidly obese patients. LEARNING OBJECTIVES: After reading this article and taking the test, you should be able to: 1. Discuss problems experienced by persons who are morbidly obese. 2. Describe nursing interventions useful in caring for morbidly obese patients.

1. Morbid obesity is defined as a body mass index greater than

a. 40 kg/m2.

b. 45 kg/m2.

c. 50 kg/m2.

2. Research has shown that genetics predisposes morbid obesity in

a. less than 25% of patients.

b. 55% of patients.

c. 75% of patients.

3. Researchers are examining how hormones relate to obesity through the way they affect

a. the way calories are processed.

b. satiety.

c. the way the body expends energy.

4. Morbidly obese patients are at high risk for the following cardiovascular complicationsexcept

a. deep vein thrombosis.

b. cardiac tamponade.

c. fluid volume overload

5. To best hear a morbidly obese patient's heart sounds,

a. ask the patient to lie as flat as possible.

b. evaluate while the patient holds his breath.

c. auscultate while the patient lies on his left side.

6. Using a blood pressure cuff that's too small for your patient can

a. give a false low reading.

b. give a false high reading.

c. make auscultation difficult.

7. The acronym OHS stands for

a. obesity hyperlipidemia syndrome.

b. obesity hypertension syndrome.

c. obesity hypoventilation syndrome.

8. Pickwickian syndrome causes the patient to

a. have an enhanced respiratory drive.

b. become hypoxic.

c. become hypocapnic.

9. To facilitate lung expansion, position the morbidly obese patient

a. by having him lie on his left side.

b. with the head of the bed elevated to 30 degrees.

c. with the head of the bed elevated to 90 degrees.

10. To help obese patients avoid urinary incontinence, the author recommends

a. obtaining an over-the-toilet commode.

b. inserting an indwelling catheter.

c. encouraging male patients to use urinals in the recumbent position.

11. Fecal incontinence can be a problem for a morbidly obese patient because of

a. the large volume of food eaten.

b. a tendency toward constipation and compensatory laxative use.

c. the pressure of an enlarged abdomen on the bowel.

12. Which statement about obesity and type 2 diabetes is correct?

a. Type 2 diabetes has tripled in the last 10 years due to the growing incidence of obesity.

b. Ninety-seven percent of type 2 diabetes cases are due to extreme weight gain.

c. Obese patients who also have diabetes are unlikely to experience hypoglycemia.

13. Why are morbidly obese patients particularly prone to fungal infections?

a. Patient skin folds cause irritation and trap moisture.

b. Fungal infections thrive on adipose tissue.

c. Morbidly obese people lose interest in hygiene.

14. All of the following statements about emergency care of a morbidly obese patient are correctexcept

a. tracheotomy may take longer to accomplish.

b. ventilation by mask isn't effective due to a short, thick neck.

c. a central line may be required because of difficult intravenous access.

15. To determine the degree of pitting edema, press the skin for 5 seconds and measure

a. the indentation in centimeters.

b. the indentation in inches.

c. how long it takes the indentation to return to baseline.

16. Pickwickian syndrome is characterized by sleep apnea

a. in addition to hypertension and anemia.

b. caused by excess fatty tissue around the glottis and trachea.

c. caused by excess fatty tissue surrounding chest muscles.





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