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ARCHIVES > NSG 100 Week 7 Harding Chapter 45 Obesity > Flashcards

NSG 100 Week 7 Harding Chapter 45 Obesity Flashcards

1
Q

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

A

primary, secondary

(Harding45 Sherpath Obesity & Health Risks Key Points)

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2
Q

The ___, ___, and ___ synthesize hormones and peptides that stimulate or inhibit appetite.

A

hypothalamus, gut, and adipose tissue

(Harding45 Sherpath Obesity & Health Risks Key Points)

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3
Q

The hypothalamus, gut, and adipose tissue synthesize ____ and ____ that stimulate or inhibit appetite

A

hormones and peptides

(Harding45 Sherpath Obesity & Health Risks Key Points)

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4
Q

Obesity can lead to several medical problems, including: (6)

A

osteoarthritis, sleep apnea, gastroesophageal reflux disease (GERD), gallstones, non-alcoholic steatohepatitis, and cancer.

(Harding45 Sherpath Obesity & Health Risks Key Points)

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5
Q

The first step in the treatment of obesity is to:

A

determine whether any physical conditions are present that may be causing or contributing to obesity

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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6
Q

The degree to which a patient is classified as underweight, healthy (normal) weight, overweight, or obese can be assessed by using (4):

A

body weight, a body mass index (BMI) chart, waist circumference, or waist-to-hip ratio.

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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7
Q

People with fat primarily in the ______ area have “apple-shaped body”

A

abdominal

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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8
Q

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).

A

greater

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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9
Q

Those whose fat is mainly in the ______ have a “pear-shaped body”

A

upper legs

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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10
Q

The overall goals are that the patient with obesity will (4):

A

(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)

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11
Q

_______ is a cornerstone for any weight loss or weight maintenance program.

A

Restricting dietary intake so that it is below energy requirements

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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12
Q

Exercise is an important part of a weight control program. Exercise should be done daily, preferably for _______ minutes.

A

30 to 60

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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13
Q

Useful basic techniques for behavioral modification include (3):

A

self-monitoring
stimulus control
rewards

(Harding45 Sherpath Nursing & Interprofessional Management: Obesity)

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14
Q

Drug therapy is reserved for adults with a BMI of:

A

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)

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15
Q

_______ is currently the only treatment that has a successful and lasting impact for sustained weight loss for those with extreme obesity.

A

Bariatric surgery

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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16
Q

Surgeries are classified as (3):

A

restrictive
malabsorptive
or a combination of restrictive and malabsorptive surgeries

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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17
Q

The _____ involves creating a small gastric pouch and attaching it directly to the small intestine using a Y-shaped limb of the small bowel.

A

RYGB

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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18
Q

In _______ procedures, the small intestine is shortened or bypassed so less food absorbed.

A

malabsorptive

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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19
Q

A _____ or _______ controls nerve impulses from the brain to the stomach.

A

gastric pacemaker, or gastric electrical stimulation

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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20
Q

A _______ is the surgical removal of excess skin and adipose tissue.

A

lipectomy (adipectomy)

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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21
Q

______ is not usually recommended for older patients because their skin is less elastic and will not accommodate new underlying shape.

A

Liposuction

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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22
Q

Concerns after bariatric surgery include (3):

A

wound healing
pain
risk for infection

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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23
Q

Older adults with obesity are more at risk for (3):

A

urinary incontinence
hypoventilation
sleep apnea

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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24
Q

_________ is a collection of risk factors that increase a person’s chance of developing cardiovascular disease and diabetes.

A

Metabolic syndrome

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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25
Q

The signs of ______ are impaired fasting blood glucose, hypertension, abnormal cholesterol levels, and obesity.

A

metabolic syndrome

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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26
Q

The signs of metabolic syndrome are (4):

A

impaired fasting blood glucose
hypertension
abnormal cholesterol levels
obesity

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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27
Q

Interventions focus on reducing risk factors of cardiovascular disease and type 2 diabetes (5):

A

reducing LDL cholesterol
stopping smoking
lowering BP
losing weight
reducing glucose levels

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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28
Q

____ %of adults in the United States are obese.

A

43%

(Harding45 Obesity p1030)

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29
Q

Calorie intake over energy expenditure for body’s metabolic demands is _____ obesity.

A

Primary

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30
Q

______ obesity, is when a medical problem caused the weight gain.

A

secondary

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31
Q

_______, made in the hypothalamus, is a powerful appetite stimulant.

A

Neuropeptide Y
1031

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32
Q

Neuropeptide Y is made in the

A

hypothalamus

1031

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33
Q

Neuropeptide Y is

A

is a powerful appetite stimulant

1031

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34
Q

The ____, ____, and ____ synthesize hormones and peptides that stimulate or inhibit appetite

A

hypothalamus, gut, and adipose tissue

1031

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35
Q

The hypothalamus, gut, and adipose tissue synthesize _____ and _____ that stimulate or inhibit appetite

A

hormones and peptides

1031

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36
Q

When overeating develops at an early age and continues into adulthood, it alters one’s ability to sense ______

A

fullness (satiety)

1031

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37
Q

______ is made in the adipocyte. It acts in the hypothalamus to suppress appetite and increase fat metabolism.

A

Leptin

1032

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38
Q

Leptin is made in the _____ . It acts in the hypothalamus to suppress appetite and increase fat metabolism.

A

adipocyte

1032

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39
Q

Leptin is made in the adipocyte. It acts in the _______ to suppress appetite and increase fat metabolism.

A

hypothalamus

1032

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40
Q

Leptin is made in the adipocyte. It acts in the hypothalamus to _____ and _____.

A

suppress appetite and increase fat metabolism

1032

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41
Q

_______ (44.8%) and ______ (49.6%) have the highest rates of obesity.

A

Hispanics, Blacks

1032

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42
Q

Among women, ______(56.9%) have the highest prevalence of being obese.

A

Blacks

1032

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43
Q

Among _____ , Hispanics (45.7%) have the highest prevalence of being obese.

A

men

1032

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44
Q

_____ have the lowest prevalence of being obese.

A

Asian Americans

1032

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45
Q

most obese persons have high leptin levels, suggesting they are ________

A

leptin resistant

1032

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46
Q

most obese persons have _______ leptin levels, suggesting they are leptin resistant

A

high

1032

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47
Q

______, a gut hormone, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger

A

Ghrelin

1032

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48
Q

Ghrelin, a _________, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger

A

gut hormone

1032

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49
Q

Ghrelin, a gut hormone, regulates _______ by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger

A

appetite

1032

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50
Q

Ghrelin, a gut hormone, regulates appetite by _______. It acts in the hypothalamus and the brain’s pleasure centers to stimulate hunger

A

inhibiting leptin

1032

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51
Q

Ghrelin, a gut hormone, regulates appetite by inhibiting leptin. It acts ________ and _____ to stimulate hunger

A

in the hypothalamus and the brain’s pleasure centers

1032

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52
Q

Ghrelin, a gut hormone, regulates appetite by inhibiting leptin. It acts in the hypothalamus and the brain’s pleasure centers to ________

A

stimulate hunger

1032

53
Q

________ make substances we call adipokines.

A

Adipocytes

1031

54
Q

Adipocytes make substances we call _______

A

adipokines

1031

55
Q

______ play roles in glucose and lipid metabolism, insulin sensitivity, energy homeostasis, inflammation, immunity, and vascular function.

A

Adipokines

1031

56
Q

In a non-obese person, ______ levels are higher when a person is hungry and decrease after eating

A

ghrelin

1031

57
Q

Gastric bypass patients (do or do not) have the premeal increase in ghrelin.

A

do not

1031

58
Q

Excess ________ is associated with adipokine dysfunction, which leads to insulin resistance, dyslipidemia, and high blood pressure.

A

visceral fat

1031

59
Q

Excess visceral fat is associated with _________, which leads to insulin resistance, dyslipidemia, and high blood pressure.

A

adipokine dysfunction

1031

60
Q

_______ obesity is a significant risk factor for cardiovascular disease (CVD) and stroke in both men and women.

A

Android

1031

61
Q

______ is linked with increased low-density lipoproteins (LDLs), high triglycerides, and decreased high-density lipoproteins (HDLs).

A

Android obesity

1031

62
Q

______ is a condition in which lipids are deposited in the liver, resulting in a fatty liver.

A

Nonalcoholic steatohepatitis (NASH)

1033

63
Q

What is nonalcoholic steatohepatitis (NASH)

A

A condition in which lipids are deposited in the liver, resulting in a fatty liver.

1033

64
Q

What ways are there to classify a patient’s body weight? (4)

A

BMI, waist circumference, waist-to-hip ratio (WHR), and body shape.

1035

65
Q

What BMI is underweight?

A

<18.5 kg/m2

1035

66
Q

What BMI is normal?

A

18.5 - 24.9 kg/m2

1035

67
Q

What BMI is overweight?

A

25 - 29.9 kg/m2

1035

68
Q

What BMI is obese?

A

> 30 kg/m2

1035

69
Q

What BMI is extreme obesity (morbid or severe)

A

> 40 kg/m2

1035

70
Q

How do you measure waist circumference?

A

Just above the iliac crest after the patient has exhaled.

71
Q

People with fat mainly in the ______ area and an apple-shaped body have android obesity

A

abdominal

1036

72
Q

Those with fat distribution in the ____ with a pear-shaped body have gynoid obesity.

A

upper legs

1036

73
Q

The overall goals are that the patient with obesity will (4)

A

(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

74
Q

How many minutes of moderate exercise per week is recommended?

A

150

1040

75
Q

How many minutes of vigorous exercise per week is recommended?

A

75

1040

76
Q

Drug therapy is reserved for adults with a BMI of

A

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

77
Q

What is the brand name for bupropion/naltrexone

A

Contrave

1040 Table 45.8

78
Q

What is the generic name for Contrave

A

buproprion/naltrexone

1040 Table 45.8

79
Q

What is the brand name for liraglutide?

A

Saxenda

1040 Table 45.8

80
Q

What is the generic name for Saxenda?

A

liraglutide

1040 Table 45.8

81
Q

orlistat is generic for what?

A

(Xenical, Allī [low-dose form available over the counter])

1040 Table 45.8

82
Q

What is generic name of Xenical?

A

orlistat

1040 Table 45.8

83
Q

phentermine/topiramate ER

A

Qsmyia

1040 Table 45.8

84
Q

Qsmyia

A

phentermine/topiramate ER

1040 Table 45.8

85
Q

semaglutide

A

Wegovy

1040 Table 45.8

86
Q

Wegovy

A

semaglutide

1040 Table 45.8

87
Q

Which medication has the following side effects: nausea, constipation, headache, dizziness, insomnia, dry mouth

A

bupropion/naltrexone (Contrave)

1040 Table 45.8

88
Q

Which medication has the following side effects: nausea, diarrhea, headache, fatigue, dizziness

A

liraglutide (Saxenda)

1040 Table 45.8

89
Q

Which medication has the following side effects: stool leakage, flatulence, diarrhea, abdominal bloating, especially if a high-fat diet is consumed

A

orlistat (Xenica)

1040 Table 45.8

90
Q

Which medication has the following side effects: dizziness, insomnia, dry mouth, headache, high blood pressure

A

phentermine/topiramate ER (Qsmyia)

1040 Table 45.8

91
Q

Which medication has the following side effects: abdominal pain, constipation

A

Plenity

1040 Table 45.8

92
Q

Which medication has the following side effects: GI distress

A

semaglutide (Wegovy)

1040 Table 45.8

93
Q

What is the mechanism of action for liraglutide (Saxenda)

A

Glucagon-like peptide 1 (GLP-1) agonist that induces satiety

1040 Table 45.8

94
Q

What is the mechanism of action for bupropion/naltrexone (Contrave)

A

bupropion: antidepressant
naltrexone: opioid antagonist

1040 Table 45.8

95
Q

What is the mechanism of action for orlistat (Xenical)

A

Inhibits gastrointestinal (GI) lipase
Blocks fat breakdown and absorption in intestine
Results in undigested fat excreted in feces

1040 Table 45.8

96
Q

What is the mechanism of action for phentermine/topiramate ER (Qsmyia)

A

phentermine: Sympathomimetic
topiramate: Decreases appetite

1040 Table 45.8

97
Q

What is the mechanism of action for Plenity

A

Gel pieces increase the volume of stomach and small intestine contents
Induces satiety

1040 Table 45.8

98
Q

What is the mechanism of action for semaglutide (Wegovy)

A

Mimics GLP-1
Induces satiety

1041

99
Q

Bariatric surgeries fall into 1 of 3 broad categories:

A

restrictive
malabsorptive
combination of malabsorptive and restrictive

1041

100
Q

_______ procedures reduce the size of the stomach, so less food is eaten.

A

Restrictive

(1041 Table 45.9)

101
Q

In _______ procedures, the small intestine is shortened or bypassed, so less food is absorbed

A

malabsorptive

(1041 Table 45.9)

102
Q

Adjustable Gastric Banding (AGB) (Lap-Band, Realize Band) are what kind of surgery?

A

Restrictive

(1041 Table 45.9)

103
Q

Sleeve Gastrectomy (Gastric Sleeve) are what kind of surgery?

A

Restrictive

(1041 Table 45.9)

104
Q

Gastric Plication is what kind of surgery?

A

Restrictive

(1041 Table 45.9)

105
Q

Intragastric Balloon is what kind of surgery?

A

Restrictive

(1041 Table 45.9)

106
Q

Biliopancreatic Diversion (BPD) With or Without Duodenal Switch is what kind of surgery?

A

Malabsorptive

(1041 Table 45.9)

107
Q

Roux-en-Y Gastric Bypass (RYGB) is what kind of surgery?

A

Combination of restrictive and malabsorptive

(1041 Table 45.9)

108
Q

Gastric Pacemaker (Gastric Electrical Stimulation Device is what kind of surgery?

A

Combination of restrictive and malabsorptive

(1041 Table 45.9)

109
Q

_________ involves limiting the stomach size with an inflatable band placed around the fundus of the stomach

A

Adjustable gastric banding (AGB)

1043

110
Q

In the _________, about 75% of the stomach is removed, leaving a sleeve-shaped stomach

A

sleeve gastrectomy (gastric sleeve)

1043

111
Q

_________ 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.

A

Gastric plication

1043

112
Q

The ______ involves creating a small gastric pouch and attaching it directly to the small intestine using a Y-shaped limb of the small bowel

A

Roux-en-Y gastric bypass (RYGB)

1044

113
Q

A __________ is the surgical removal of excess skin and adipose tissue.

A

lipectomy (adipectomy)

1047

114
Q

_____ is a group of metabolic risk factors that increase a person’s chance of developing CVD, stroke, and diabetes.

A

Metabolic syndrome

1047

115
Q

A waist circumference greater or equal to ____ in men, or ____, in women is a diagnostic criteria for metabolic syndrome.

A

40”, 35”

1047 Table 45.11

116
Q

Triglycerides greater than ____ or drug treatment for triglycerides is a diagnostic criteria for metabolic syndrome.

A

150mg/dL (1.7mmol/L)

1047 Table 45.11

117
Q

HDL Cholesterol of _____ in men or ___ in women, OR drug treatment for high cholesterol is a diagnostic criteria for metabolic syndrome.

A

<40mg/dL in men (0.9mmol/L)
<50mg/dL in women (1.1mmol/L)

1047 Table 45.11

118
Q

A fasting glucose of ______ or drug treatment for elevated glucose is a diagnostic criteria for metabolic syndrome.

A

Greater than or equal to 100mg/dL

1047 Table 45.11

119
Q

A systolic BP of _____ or diastolic BP of ____, or drug treatment for hypertension is diagnostic criteria for metabolic syndrome.

A

Greater than or equal to 130/85

1047 Table 45.11

120
Q

The signs of _______ are impaired fasting glucose, hypertension, abnormal cholesterol levels, and obesity

A

metabolic syndrome

1047

121
Q

Those who are obese live _______ years less than people of normal weight.

A

6 to 7

1046

122
Q

A ________, controls nerve impulses from the brain to the stomach.

A

gastric pacemaker, or gastric electrical stimulation

1044

123
Q

______ is when gastric contents empty too rapidly into the small intestine, overwhelming its ability to digest nutrients

A

dumping syndrome

1044

124
Q

_____ is currently the only treatment that has a successful and lasting impact for sustained weight loss for those with extreme obesity

A

Surgery

1041

125
Q

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.

A

800

1039

126
Q

Setting a realistic and healthy goal, such as losing _____ per week,

A

1 to 2 pounds

1038

127
Q
A
128
Q

________ reduces either the size of the stomach, which causes the patient to feel full more quickly, or the amount allowed to enter the stomach.

A

Restrictive surgery

(Harding45 Sherpath Surgical Interventions and Metabolic Syndrome)

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