NSG 100 Week 7 Harding Chapter 45 Obesity Flashcards
Most obese persons have ______obesity, which is excess calorie intake over energy expenditure for the body’s metabolic demands. Others have _______ obesity, in which a medical problem caused the weight gain
primary, secondary
(Harding45 Sherpath Obesity & Health Risks Key Points)
The ___, ___, and ___ synthesize hormones and peptides that stimulate or inhibit appetite.
hypothalamus, gut, and adipose tissue
(Harding45 Sherpath Obesity & Health Risks Key Points)
The hypothalamus, gut, and adipose tissue synthesize ____ and ____ that stimulate or inhibit appetite
hormones and peptides
(Harding45 Sherpath Obesity & Health Risks Key Points)
Obesity can lead to several medical problems, including: (6)
osteoarthritis, sleep apnea, gastroesophageal reflux disease (GERD), gallstones, non-alcoholic steatohepatitis, and cancer.
(Harding45 Sherpath Obesity & Health Risks Key Points)
The first step in the treatment of obesity is to:
determine whether any physical conditions are present that may be causing or contributing to obesity
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
The degree to which a patient is classified as underweight, healthy (normal) weight, overweight, or obese can be assessed by using (4):
body weight, a body mass index (BMI) chart, waist circumference, or waist-to-hip ratio.
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
People with fat primarily in the ______ area have “apple-shaped body”
abdominal
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
People with fat primarily in the abdominal area (apple-shaped body) are at a _______ risk for obesity-related complications than those whose fat is mainly in the upper legs (pear-shaped body).
greater
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
Those whose fat is mainly in the ______ have a “pear-shaped body”
upper legs
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
The overall goals are that the patient with obesity will (4):
(1) modify eating patterns
(2) take part in a regular exercise
(3) achieve and maintain weight loss to a specified level
(4) minimize or prevent health problems related to obesity
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
_______ is a cornerstone for any weight loss or weight maintenance program.
Restricting dietary intake so that it is below energy requirements
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
Exercise is an important part of a weight control program. Exercise should be done daily, preferably for _______ minutes.
30 to 60
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
Useful basic techniques for behavioral modification include (3):
self-monitoring
stimulus control
rewards
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
Drug therapy is reserved for adults with a BMI of:
30 kg/m2 or greater (obese) or adults with a BMI of 27 kg/m2 or greater (overweight) who have at least one weight-related condition, such as hypertension, type 2 diabetes, or dyslipidemia.
(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)
_______ is currently the only treatment that has a successful and lasting impact for sustained weight loss for those with extreme obesity.
Bariatric surgery
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
Surgeries are classified as (3):
restrictive
malabsorptive
or a combination of restrictive and malabsorptive surgeries
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
The _____ involves creating a small gastric pouch and attaching it directly to the small intestine using a Y-shaped limb of the small bowel.
RYGB
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
In _______ procedures, the small intestine is shortened or bypassed so less food absorbed.
malabsorptive
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
A _____ or _______ controls nerve impulses from the brain to the stomach.
gastric pacemaker, or gastric electrical stimulation
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
A _______ is the surgical removal of excess skin and adipose tissue.
lipectomy (adipectomy)
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
______ is not usually recommended for older patients because their skin is less elastic and will not accommodate new underlying shape.
Liposuction
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
Concerns after bariatric surgery include (3):
wound healing
pain
risk for infection
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
Older adults with obesity are more at risk for (3):
urinary incontinence
hypoventilation
sleep apnea
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
_________ is a collection of risk factors that increase a person’s chance of developing cardiovascular disease and diabetes.
Metabolic syndrome
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
The signs of ______ are impaired fasting blood glucose, hypertension, abnormal cholesterol levels, and obesity.
metabolic syndrome
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
The signs of metabolic syndrome are (4):
impaired fasting blood glucose
hypertension
abnormal cholesterol levels
obesity
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
Interventions focus on reducing risk factors of cardiovascular disease and type 2 diabetes (5):
reducing LDL cholesterol
stopping smoking
lowering BP
losing weight
reducing glucose levels
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
____ %of adults in the United States are obese.
43%
(Harding45 Obesity p1030)
Calorie intake over energy expenditure for body’s metabolic demands is _____ obesity.
Primary
______ obesity, is when a medical problem caused the weight gain.
secondary
_______, made in the hypothalamus, is a powerful appetite stimulant.
Neuropeptide Y
1031
Neuropeptide Y is made in the
hypothalamus
1031
Neuropeptide Y is
is a powerful appetite stimulant
1031
The ____, ____, and ____ synthesize hormones and peptides that stimulate or inhibit appetite
hypothalamus, gut, and adipose tissue
1031
The hypothalamus, gut, and adipose tissue synthesize _____ and _____ that stimulate or inhibit appetite
hormones and peptides
1031
When overeating develops at an early age and continues into adulthood, it alters one’s ability to sense ______
fullness (satiety)
1031
______ is made in the adipocyte. It acts in the hypothalamus to suppress appetite and increase fat metabolism.
Leptin
1032
Leptin is made in the _____ . It acts in the hypothalamus to suppress appetite and increase fat metabolism.
adipocyte
1032
Leptin is made in the adipocyte. It acts in the _______ to suppress appetite and increase fat metabolism.
hypothalamus
1032
Leptin is made in the adipocyte. It acts in the hypothalamus to _____ and _____.
suppress appetite and increase fat metabolism
1032
_______ (44.8%) and ______ (49.6%) have the highest rates of obesity.
Hispanics, Blacks
1032
Among women, ______(56.9%) have the highest prevalence of being obese.
Blacks
1032
Among _____ , Hispanics (45.7%) have the highest prevalence of being obese.
men
1032
_____ have the lowest prevalence of being obese.
Asian Americans
1032
most obese persons have high leptin levels, suggesting they are ________
leptin resistant
1032
most obese persons have _______ leptin levels, suggesting they are leptin resistant
high
1032
______, a gut hormone, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger
Ghrelin
1032
Ghrelin, a _________, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger
gut hormone
1032
Ghrelin, a gut hormone, regulates _______ by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger
appetite
1032
Ghrelin, a gut hormone, regulates appetite by _______. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger
inhibiting leptin
1032
Ghrelin, a gut hormone, regulates appetite by inhibiting leptin. It acts ________ and _____ to stimulate hunger
in the hypothalamus and the brain’s pleasure centers
1032
Ghrelin, a gut hormone, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to ________
stimulate hunger
1032
________ make substances we call adipokines.
Adipocytes
1031
Adipocytes make substances we call _______
adipokines
1031
______ play roles in glucose and lipid metabolism, insulin sensitivity, energy homeostasis, inflammation, immunity, and vascular function.
Adipokines
1031
In a non-obese person, ______ levels are higher when a person is hungry and decrease after eating
ghrelin
1031
Gastric bypass patients (do or do not) have the premeal increase in ghrelin.
do not
1031
Excess ________ is associated with adipokine dysfunction, which leads to insulin resistance, dyslipidemia, and high blood pressure.
visceral fat
1031
Excess visceral fat is associated with _________, which leads to insulin resistance, dyslipidemia, and high blood pressure.
adipokine dysfunction
1031
_______ obesity is a significant risk factor for cardiovascular disease (CVD) and stroke in both men and women.
Android
1031
______ is linked with increased low-density lipoproteins (LDLs), high triglycerides, and decreased high-density lipoproteins (HDLs).
Android obesity
1031
______ is a condition in which lipids are deposited in the liver, resulting in a fatty liver.
Nonalcoholic steatohepatitis (NASH)
1033
What is nonalcoholic steatohepatitis (NASH)
A condition in which lipids are deposited in the liver, resulting in a fatty liver.
1033
What ways are there to classify a patient’s body weight? (4)
BMI, waist circumference, waist-to-hip ratio (WHR), and body shape.
1035
What BMI is underweight?
<18.5 kg/m2
1035
What BMI is normal?
18.5 - 24.9 kg/m2
1035
What BMI is overweight?
25 - 29.9 kg/m2
1035
What BMI is obese?
> 30 kg/m2
1035
What BMI is extreme obesity (morbid or severe)
> 40 kg/m2
1035
How do you measure waist circumference?
Just above the iliac crest after the patient has exhaled.
People with fat mainly in the ______ area and an apple-shaped body have android obesity
abdominal
1036
Those with fat distribution in the ____ with a pear-shaped body have gynoid obesity.
upper legs
1036
The overall goals are that the patient with obesity will (4)
(1) modify eating patterns
(2) take part in regular exercise
(3) achieve and maintain weight loss to a specified level
(4) minimize or prevent health problems related to obesity
How many minutes of moderate exercise per week is recommended?
150
1040
How many minutes of vigorous exercise per week is recommended?
75
1040
Drug therapy is reserved for adults with a BMI of
30 kg/m2 or greater (obese) or adults with a BMI of 27 kg/m2 or greater (overweight) who have at least 1 weight-related condition, such as hypertension, type 2 diabetes, or dyslipidemia
What is the brand name for bupropion/naltrexone
Contrave
1040 Table 45.8
What is the generic name for Contrave
buproprion/naltrexone
1040 Table 45.8
What is the brand name for liraglutide?
Saxenda
1040 Table 45.8
What is the generic name for Saxenda?
liraglutide
1040 Table 45.8
orlistat is generic for what?
(Xenical, Allī [low-dose form available over the counter])
1040 Table 45.8
What is generic name of Xenical?
orlistat
1040 Table 45.8
phentermine/topiramate ER
Qsmyia
1040 Table 45.8
Qsmyia
phentermine/topiramate ER
1040 Table 45.8
semaglutide
Wegovy
1040 Table 45.8
Wegovy
semaglutide
1040 Table 45.8
Which medication has the following side effects: nausea, constipation, headache, dizziness, insomnia, dry mouth
bupropion/naltrexone (Contrave)
1040 Table 45.8
Which medication has the following side effects: nausea, diarrhea, headache, fatigue, dizziness
liraglutide (Saxenda)
1040 Table 45.8
Which medication has the following side effects: stool leakage, flatulence, diarrhea, abdominal bloating, especially if a high-fat diet is consumed
orlistat (Xenica)
1040 Table 45.8
Which medication has the following side effects: dizziness, insomnia, dry mouth, headache, high blood pressure
phentermine/topiramate ER (Qsmyia)
1040 Table 45.8
Which medication has the following side effects: abdominal pain, constipation
Plenity
1040 Table 45.8
Which medication has the following side effects: GI distress
semaglutide (Wegovy)
1040 Table 45.8
What is the mechanism of action for liraglutide (Saxenda)
Glucagon-like peptide 1 (GLP-1) agonist that induces satiety
1040 Table 45.8
What is the mechanism of action for bupropion/naltrexone (Contrave)
bupropion: antidepressant
naltrexone: opioid antagonist
1040 Table 45.8
What is the mechanism of action for orlistat (Xenical)
Inhibits gastrointestinal (GI) lipase
Blocks fat breakdown and absorption in intestine
Results in undigested fat excreted in feces
1040 Table 45.8
What is the mechanism of action for phentermine/topiramate ER (Qsmyia)
phentermine: Sympathomimetic
topiramate: Decreases appetite
1040 Table 45.8
What is the mechanism of action for Plenity
Gel pieces increase the volume of stomach and small intestine contents
Induces satiety
1040 Table 45.8
What is the mechanism of action for semaglutide (Wegovy)
Mimics GLP-1
Induces satiety
1041
Bariatric surgeries fall into 1 of 3 broad categories:
restrictive
malabsorptive
combination of malabsorptive and restrictive
1041
_______ procedures reduce the size of the stomach, so less food is eaten.
Restrictive
(1041 Table 45.9)
In _______ procedures, the small intestine is shortened or bypassed, so less food is absorbed
malabsorptive
(1041 Table 45.9)
Adjustable Gastric Banding (AGB) (Lap-Band, Realize Band) are what kind of surgery?
Restrictive
(1041 Table 45.9)
Sleeve Gastrectomy (Gastric Sleeve) are what kind of surgery?
Restrictive
(1041 Table 45.9)
Gastric Plication is what kind of surgery?
Restrictive
(1041 Table 45.9)
Intragastric Balloon is what kind of surgery?
Restrictive
(1041 Table 45.9)
Biliopancreatic Diversion (BPD) With or Without Duodenal Switch is what kind of surgery?
Malabsorptive
(1041 Table 45.9)
Roux-en-Y Gastric Bypass (RYGB) is what kind of surgery?
Combination of restrictive and malabsorptive
(1041 Table 45.9)
Gastric Pacemaker (Gastric Electrical Stimulation Device is what kind of surgery?
Combination of restrictive and malabsorptive
(1041 Table 45.9)
_________ involves limiting the stomach size with an inflatable band placed around the fundus of the stomach
Adjustable gastric banding (AGB)
1043
In the _________, about 75% of the stomach is removed, leaving a sleeve-shaped stomach
sleeve gastrectomy (gastric sleeve)
1043
_________ is similar to a gastric sleeve in that it reduces the size of the stomach. It is done by folding the stomach wall inward and then placing sutures to secure the folded stomach wall.
Gastric plication
1043
The ______ involves creating a small gastric pouch and attaching it directly to the small intestine using a Y-shaped limb of the small bowel
Roux-en-Y gastric bypass (RYGB)
1044
A __________ is the surgical removal of excess skin and adipose tissue.
lipectomy (adipectomy)
1047
_____ is a group of metabolic risk factors that increase a person’s chance of developing CVD, stroke, and diabetes.
Metabolic syndrome
1047
A waist circumference greater or equal to ____ in men, or ____, in women is a diagnostic criteria for metabolic syndrome.
40”, 35”
1047 Table 45.11
Triglycerides greater than ____ or drug treatment for triglycerides is a diagnostic criteria for metabolic syndrome.
150mg/dL (1.7mmol/L)
1047 Table 45.11
HDL Cholesterol of _____ in men or ___ in women, OR drug treatment for high cholesterol is a diagnostic criteria for metabolic syndrome.
<40mg/dL in men (0.9mmol/L)
<50mg/dL in women (1.1mmol/L)
1047 Table 45.11
A fasting glucose of ______ or drug treatment for elevated glucose is a diagnostic criteria for metabolic syndrome.
Greater than or equal to 100mg/dL
1047 Table 45.11
A systolic BP of _____ or diastolic BP of ____, or drug treatment for hypertension is diagnostic criteria for metabolic syndrome.
Greater than or equal to 130/85
1047 Table 45.11
The signs of _______ are impaired fasting glucose, hypertension, abnormal cholesterol levels, and obesity
metabolic syndrome
1047
Those who are obese live _______ years less than people of normal weight.
6 to 7
1046
A ________, controls nerve impulses from the brain to the stomach.
gastric pacemaker, or gastric electrical stimulation
1044
______ is when gastric contents empty too rapidly into the small intestine, overwhelming its ability to digest nutrients
dumping syndrome
1044
_____ is currently the only treatment that has a successful and lasting impact for sustained weight loss for those with extreme obesity
Surgery
1041
A very low-calorie diet plan that limits calories to a total of ____ or less per day may be prescribed if rapid weight loss is needed.
800
1039
Setting a realistic and healthy goal, such as losing _____ per week,
1 to 2 pounds
1038
________ reduces either the size of the stomach, which causes the patient to feel full more quickly, or the amount allowed to enter the stomach.
Restrictive surgery
(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)
