CH 42: Assessment and Management of Patients Obesity

A few months after bariatric surgery, a 56-year-old man tells the nurse, My skin is hanging in folds. I think I need cosmetic surgery. Which response by the nurse is most appropriate?

Cosmetic surgery is a possibility once your weight has stabilized.

After vertical banded gastroplasty, a 42-year-old male patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the postoperative plan of care?

Support the surgical incision during patient coughing and turning in bed.

The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?

Drink fluids between meals but not with meals.

Which adult will the nurse plan to teach about risks associated with obesity?

Man with a 42 in waist and 44 in hips

A 61-year-old man is being admitted for bariatric surgery. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP)?

Assist with IV insertion by holding adipose tissue out of the way.

After successfully losing 1 lb weekly for several months, a patient at the clinic has not lost any weight for the last month. The nurse should first

ask the patient whether there have been any changes in exercise or diet patterns.

Which finding for a patient who has been taking orlistat (Xenical) is most important to report to the health care provider?

The patient is pale and has many bruises.

A 40-year-old obese woman reports that she wants to lose weight. Which question should the nurse ask first?

What factors led to your obesity?

The nurse is caring for a 54-year-old female patient on the first postoperative day after a Roux-en-Y gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon?

Emesis of bile-colored fluid past the nasogastric (NG) tube

Which information will the nurse prioritize in planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass?

Instructing the patient on coughing and breathing techniques

After bariatric surgery, a patient who is being discharged tells the nurse, I prefer to be independent. I am not interested in any support groups. Which response by the nurse is best?

Tell me what types of resources you think you might use after this surgery.

A client just returned to the surgical unit after a gastric bypass. What action by the nurse is the priority?

Ensure an adequate airway.

A client is in the bariatric clinic 1 month after having gastric bypass surgery. The client is crying and says I didnt know it would be this hard to live like this. What response by the nurse is best?

Assess the clients coping and support systems

A client is awaiting bariatric surgery in the morning. What action by the nurse is most important?

Beginning venous thromboembolism prophylaxis