Medical Nutrition Therapy: A Case Study Approach 4th Edition Solution Manual

2-1 Case Questions for Medical Nutrition Therapy: A Case Study Approach 4th ed. Title: Case 2 – Bariatric Surgery for Morbid Obesity Instructions: Answer the questions below. You may print your answers or e-mail them to your instructor. Questions: 1. Discuss the classification of morbid obesity. 2. Describe the primary health risks involved with untreated morbid obesity. What health risks does Mr. McKinley present with? 3. What are the standard adult criteria for consideration as a candidate for bariatric surgery? After reading Mr. McKinley’s medical record, determine the criteria that allow him to qualify for surgery. 4. By performing an Internet search or literature review, find one example of a bariatric surgery program. Describe the information that is provided for the patient regarding qualification for surgery. Outline the personnel involved in the evaluation and care of the patient in this particular program. 5. Describe the following surgical procedures used for bariatric surgery, including advantages, disadvantages, and potential complications. a. Roux-en-Y gastric bypass b. Vertical sleeve gastrectomy c. Adjustable gastric banding (Lap-Band®) d. Vertical banded gastroplasty e. Duodenal switch f. Biliopancreatic diversion 6. Mr. McKinley has had type 2 diabetes for several years. His physician shared with him that after surgery he will not be on any medications for his diabetes and that he may be able to stop his medications for diabetes altogether. Describe the proposed effect of bariatric surgery on the pathophysiology of type 2 diabetes. What, if any, other medical conditions might be affected by weight loss? 7. On post-op day one, Mr. McKinley was advanced to the Stage 1 Bariatric Surgery Diet. This consists of sugarfree clear liquids, broth, and sugar-free Jell-O. Why are sugar-free foods used? 8. Over the next two months, Mr. McKinley will be progressed to a pureed-consistency diet with 6–8 small meals. Describe the major goals of this diet for the Roux-en-Y patient. How might the nutrition guidelines differ if Mr. McKinley had undergone a Lap-Band procedure? 9. Mr. McKinley’s RD has discussed the importance of hydration, protein intake, and intakes of vitamins and minerals, especially calcium, iron, and B12. For each of these nutrients, describe why intake may be inadequate and explain the potential complications that could result from deficiency. 10. Assess Mr. McKinley’s height and weight. Calculate his BMI and % usual body weight. What would be a reasonable weight goal for Mr. McKinley? Give your rationale for the method you used to determine this. 11. After reading the physician’s history and physical, identify any signs or symptoms that are most likely a consequence of Mr. McKinley’s morbid obesity. 12. Identify any abnormal biochemical indices and discuss the probable underlying etiology. How might they change after weight loss? 13. Determine Mr. McKinley’s energy and protein requirements to promote weight loss. Explain the rationale for the method you used to calculate these requirements. 14. Identify at least two pertinent nutrition problems and the corresponding nutrition diagnoses. © 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 2-2 15. Determine the appropriate progression of Mr. McKinley’s post-bariatric-surgery diet. Include recommendations for any supplementation that you would advise. 16. Describe any pertinent lifestyle changes that you would view as a priority for Mr. McKinley. 17. How would you assess Mr. McKinley’s readiness for a physical activity plan? How does exercise assist in weight loss after bariatric surgery? 18. Identify the steps you would take to monitor Mr. McKinley’s nutritional status postoperatively. 19. From the literature, what is the success rate of bariatric surgery? What patient characteristics may increase the likelihood for success? 20. Mr. McKinley asks you about the possibility of bariatric surgery for a young cousin who is 10 years old. What are the criteria for bariatric surgery in children and adolescents? 21. Write an ADIME note for your inpatient nutrition assessment with initial education for the Stage 1 (liquid) diet for Mr. McKinley. © 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.