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CSOWM (2
Exam of 16 pages for the course NUR 321 - problems with excretion - renal system p at NUR 321 - problems with excretion - renal system p (CSOWM (2)
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CSOWM:Evidenced-based lifestyle therapy for treatment of obesity should include 3 components
- ANS-meal plan, physical activity,& behavior
<150 minutes of exercise/week has _________ effect on weight loss - ANS-minimal
> amounts of weight loss than 3-5% will cause additional reductions in what labs? -
ANS-reduce BP, improve LDL-C and HDL-C, reduce need for meds to control BP, BG,
lipids, and reduce triglycerides.
11-13 targetd behaviors for obesity prevention in children - ANS-11. encouraged
exclusive breastfeeding to 6 months, introduce solids at 12 months.
12. promote 60 minutes of moderate physical activity/day
13. limit consumption of energy dense foods.
2nd stage of obesity treatment in children: - ANS-2. structured wt management - step 1
(prevention plus) + specific goals: planned supervised exercise, food logs/television
logs, structure meal times with no snacks, etc.
3rd stage of obesity treatment in children: - ANS-3. comprehensive multidisciplinary
intervention - increase intensity of behavior change and frequency of visits (weekly visits
for 8-12 wks minimum)
Focus to improve: home enviro, negative energy balance from diet and exercise,
parental participation ages <12, etc.
4th stage of obesity treatment in children: - ANS-4. tertiary care intervention- stage 3 +
maturity to understand risk/willingness
A. medications: Sibutramine (SRI) >= 16 yr old, orilistat >=12 yrs old
B. V. low cal diet
C. bariatric surgery (F >= 13 yrs old, M>= 15 yrs old)
6-10 targeted behaviors for obesity prevention in children - ANS-6. eat meals together
as family
7.limit portion size
8. calcium rich diet
9. increase fiber
10. balance macronutrient content
,A dose-response of exercise to weight loss exists; if PA>150 mins/wk results in modest
weight loss (2-3 kg); how much with PA>225-420 mins/wk yield? - ANS-approximately
5-7.5 kg.
A meal plan as part of lifestyle therapy consists of: - ANS-reduced-calorie (-500-750
kcals/day), individualized based on cultural and personal preference, and can include:
mediterranean, DASH, low carb, low fat, volumetric, high protein, vegetarian, meal
replacements, and/or very low calorie diet (if under medical supervision).
A support team for pediatric bariatric surgery patients should include: - ANS-1.Surgeon
2. pediatrician
3. RDN
4. mental health specialist
5. care coordinator
6. exercise professional.
Adherence to a diet with a deficit of _____ kcals/day; regardless of macronutrient
composition, is most effective for weight loss. - ANS-500
adherence to diet vs actual diet more effective for weight loss? - ANS-adherence to diet
Advise adults that the ______ the waist circumference, the _____ the risk of CVD,
T2DM, & all cause mortality. - ANS-greater,greater
AND recommended calorie level for wt loss - ANS-F: 1200-1500 kcal/d, M: 1500-1800;
overall 500-750 kcal/day calorie deficit.
As part of a comprehensive wt loss program, a dietitian should recommend: -
ANS-portion control and meal replacement/structure meal plans.
As part of the dietitian assessment, what background information should be collected? -
ANS-1. dietary intake
2. social hx
3. motivation for weight management
4. RMR/calorie goal & usual intake
Assessing drug efficiency - ANS-evaluate safety/effectiveness monthly for first 3
months, then every 3 months after.
, At what age does the USPSTF recommend clinicians screen children for obesity and
refer them to intensive counseling/behavioral interventions to improve weight status? -
ANS-6 yrs old +
Average weight loss from Phentermine & contraindications - ANS-3-3.6 kg; not rec in
anxiety disorder, heart disease/htn, seizure, pregnancy, breastfeeding, hyperthyroidism,
drug abuse history, etc.
average weight loss via behavioral intervention in first 6 months - ANS-decrease by 8 kg
BW, average weight regain 1-2 kg/yr (faster initially).
Average weight loss with Orlistat & contraindications - ANS-2.9-3.4 kg;
preg/breastfeeding, cyclosporine, chronic malabsorption syndrome, levothyroxine,
warfarin, antiepileptic drugs.
Average wt loss with Liraglutide & contraindication - ANS-5.8 kg over year; medullary
thryoid cancer history
Average wt loss with Lorcaserin & contraindication - ANS-3.6 kg; preg/breast, SSRI,
hyperthyroid
Average wt loss with phentermine+topiramate & contraindication - ANS-6.6 kg-8.6kg;
not for use in hyperthyroid, breastfeeding/preg, etc.
Bariatric surgery exercise recommendations - ANS-150 mins/wk minimum goal 300
min/wk + 2-3x/wk strength training.
Bariatric surgery wt loss results seen for first year and following: - ANS--35% wt 1-2 yrs,
maintain 30% @ 10 years.
Behavior change strategies for counseling: - ANS-self-monitoring, motivational
interviewing, structured meal plans/replacements/portion control, goal setting, and
problem solving.`
Behavior change strategies for weight loss/maintenance: - ANS-cognitive restructuring,
contingent mngment, relapse prevention techniques, decrease rate of eating, social
support, stress management, and stimulus control/cue reduction.
behavior lifestyle therapy intervention package should include any number of the
following: - ANS-stimulus control, education, self-monitoring, goal setting, problem
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