30.6: Chapter 17
Unfolding Case Study
1. Using an online calculator, a height of 5 feet, 5 inches and a weight of 221 pounds for a female is a BMI of 36.8.
2. The patient’s BMI indicates they have obesity, which is clinically significant. Being overweight poses many risks to health, so this is something that the nurse should address at the appropriate time during the patient’s hospitalization.
3. Based on the information provided in the case study, finances may be a contributing factor. The patient reports that it is hard to eat healthy because it is expensive, indicating that her economic status affects her weight. Other contributing factors may include sociocultural or lifestyle behaviors that result in overeating or unhealthy eating habits. Additionally, the patient may not have easy access to healthy foods, making it even more difficult to eat foods that promote a healthy body weight. The patient may also be experiencing mental health disorders or body image issues that could be contributing to her weight gain. The nurse should investigate these potential factors further to better understand the patient’s specific situation.
4. First, the nurse should gather more information about factors contributing to her obesity. With this information, it will be easier for the nurse to understand the patient’s situation and provide patient-centered interventions and care. Next, the nurse should gauge the patient’s willingness to make dietary and lifestyle changes to support a healthier body weight. If the patient is unable or unwilling to make changes, the nurse must respect that and provide them with resources for when they are ready.
5. Based on the patient’s specific situation, the nurse should include teaching about limiting eating out when possible. Restaurant food is notorious for being high in sodium, which should be avoided by patients with hypertension. The nurse should also provide more generic information about the principles of healthy eating including eating a large variety of foods, choosing healthy proteins, drinking lots of water, limiting salt and alcohol intake, and avoiding processed foods.
6. After educating the patient about healthy eating, the nurse should assess the patient’s understanding by having them “teach back” the information. Additionally, the nurse could have the patient list some healthy alternatives to eating out that the patient is willing to try.