Obesity

Question 1

What exams could you perform for obesity?

Answer 1

Blood Pressure
Temperature
Heart Rate (Pulse)
Respiratory Rate
Waist Circumference (includes waist-to-hip ratio)
Dermatologic Exam
- General Skin Exam
- Skin Characteristics
- Skin Lesion Characteristics
External Eye Exam
Liver Percussion and Palpation
Heart Auscultation
Tests for Ascites
Peripheral Edema

Question 2

Findings for BP?

Answer 2

Hypertension 130/80

Hypertension would increase the probability of obesity as there is an increased prevalence of hypertension in obesity populations which puts them at risk for secondary conditions.

Question 3

findings for temperature?

Answer 3

Normal: 36.0 - 37.5°C (96.5 - 99.5°F)

Fever: 37.8

patients with obesity have a reduced ability to dissipate heat, making them more at risk for heat stroke for example.

higher risk for infection??

Question 4

Findings for heart rate?

Answer 4

Bradycardia = < 50 BPM

often attributable to untreated obstructive sleep apnea which is more common in obesity.

Question 5

findings for Waist circumference (include waist to hip ratio)

Answer 5

normal: male: 102cm female 88cm

male: 1, female 0.85

Question 5

Findings for a general skin exam?

Answer 5

• acanthosis nigricans
• stretch marks (striae)
• edema
• skin tags
• jaundice
• corneal orcus
• sclera
• spider angiomas
• lipid nodules

Question 5

findings for respiratory rate?

Answer 5

normal: 12-20 cycles/min

Obese patients have higher respiratory rates

Question 5

How to perform peripheral edema exam?

Answer 5

Girth Measurement:
- mark measurement sites (forefoot, smallest part of ankle, largest part of calf, midthigh)
- use flexible measuring tap
- compare one side to the other

abnormal:
difference of more than 1 cm for foot and ankle
2cm at calf and thigh

Pitting edema:
- assess for 5 seconds
- dorsal aspect of foot, behind medial malleolus, over the shin

0 = normal

Question 6

findings for edema?

Answer 6

the absence of edema would increase the likelihood of obesity indicating fat accumulation and not fluid.

Question 7

findings for ascites?

Answer 7

the absence of fluid would increase the likelihood of obesity indicating fat accumulation and not fluid.

Question 8

findings for heart auscultation?

Answer 8

absence of irregular heart sounds, arrhythmias, or murmurs would decrease the likeihood of CVD asscoiated with obesity as related to an increased risk of cardiovascular complications.

Question 9

finding for liver percussion and palpation?

Answer 9

Hepatomegaly (Midclavicular liver span >12 cm)
Hepatomegaly may indicate later stages of NAFLD or other liver conditions present