Chapter 22: Obesity (Children)

Question 1

Overweight

Answer 1

having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors

Question 2

Obesity

Answer 2

having excess body fat
-can present with many problems including hypertension, diabetes, shortness of breath, and increased risk for cardiovascular disease

Question 3

“Caloric Imbalance”

Answer 3

overweight and obesity are the result of caloric imbalance–too few calories expended for the amount of calories consumed–
>are affected by various genetic, behavioral, and environmental factors

Question 4

How is Childhood Obesity Determined?

Answer 4

by plotting the body mass index (BMI) percentile on a growth chart
BMI= weight (in kg) / height (in meters) squared
-Healthy= between the 5th and less than the 85th percentile
-Overweight= between the 85th and less than the 95th percentile
-Obese= greater than or equal to 95%

Question 5

When Parents ask the nurse about a delay in their child’s weight problem, the nurse can respond by asking relevant questions such as:

Answer 5

• does your child have an elevated HR or increased BP (even at rest)?
• do you feel your child is overweight?
• does your child find it difficult to walk, run, or play for any extended period of time?
• does your child (or do parents) report any bullying or teasing about being overweight?

Question 6

Diagnosis

Answer 6

based on an excess of fat in proportion to lean body mass
-BMI correlates closely with total body fat, which is estimated using dual-energy x-ray absorptiometry scanning in children who are overweight and obese

Question 7

Prevention

Answer 7

• several initiatives have been launched to address some of these issues; Affordable care act 2010 has mandated inclusion of menu labeling in restaurants and on vending machines; healthy hunger-free kids act 2010 has set nutritional standards for foods served i school and child care facilities; expanded efforts to promote breastfeeding
• motivated communities

Question 8

Nursing Care

Answer 8

geared toward helping the child and family recognize the problem and help the child return to a healthier state

• address the obesity as well as the child; can be addressed from a physical perspective, that is, addressing the concerns of potential health risks in the future (e.g. diabetes, hypertension, and weight related disorders)
• offer education and support b/c this condition needs to be approached from an emotional perspective
• the change of lifestyle habit of the family become easier to do when the entire family engages in new healthy habits together
• come from a positive perspective, such as asking the family what has gone well before or what are the current health habits the family engages in; what does the family like to do? (families will stick with what is fun and what they like to do); what is the family willing to try? (set the goals with the family’s input)
• emphasize with the child who expresses dissatisfaction with his weight and provide education and guidance r/t healthful eating and exercise

Question 9

Education/Discharge

Answer 9

-inquire about the family’s perception of food and weight
-conduct a comprehensive individual and family history (determine if there is a hx of diabetes, dyslipidemia, or cardiovascular disease)
-perform thorough physical assessment
-teach child and family about the value of a 24-hour recall, reflecting the dietary habits of the individual and family
-discuss an activity inventory of the individual and family to determine the amount of time spent in playing video-games, watching TV, and other sedentary activities within a 24-hour period
-suggest fun-filled family activities such as walking, playing catch, and going to the zoo or park
-discuss the ordered laboratory tests (e.g. metabolic profile) with the family, both the purpose and results of such tests
-obtain current height, weight, and BMI. Assess the past data
-Inform the family that the Woman Infants and Children programs provide healthy food selections
-Educate new parents about healthful attitudes about food and feeding
>also communicates that dieting is not suggested for children and adolescents; restrictive eating contributes to continued overweight or other eating problems
-focus on healthy eating habits that can last throughout the lifetime