Body Mass Index Significance to Health and Weight
The client’s BMI is 32.8 kg/m2. According to the World Health Organization’s description, this is above the normal and recommended BMI which is between 18.5 and 24.9. The BMI system is measured in groups where the health practitioners group them as safe or unsafe weight ration to height. The categories are Underweight which is any figure below the normal 18.5kg/m2. The normal BMI ranges between 18.5-25.5kg/m2. Overweight is between 25 and 29.9kg/m2 where the Obesity begins at 30kg/m2. With this in mind, the client falls in the obese category of the BMI classifications.
The age of the client and her status would require a screening tool that would take less time and collect as much information as possible concerning her diet and lifestyle. The assessment tool has to be modified to fit her needs because, first she is elderly and second she is independent. Her age and status would limit her from accessing sophisticated weight loss programs which she needs as indicated by her BMI. The level of income she can afford means that she can adjust her feeding program to ensure that she loses weight appropriately.
It would be appropriate to use a WAVE which is Weight, Activity, Variety and Excess as a screening tool. Weight assessment will be about the accumulation of the weight and how it happened (Gans, et al., 2003). This will assist in knowing how to manage the weight of the patient and how best to reduce it to a manageable level. Activity will focus on the physical activity of the patient. How often she moves and what she does when in motion. Does she exercise? Does she have time in her schedule to exercise? Such questions are answered when exploring the activity assessment. Variety is where she has a mix of a good diet in her feeding program. The valuation at this point will determine what kind of action will befit her health and weight situation (Gans, et al., 2003). Excess is about what portions are appropriate for her age and kind of activity she has in her normal schedule.
The WAVE assessment tool is friendly for her age and independent nature. She will have total control over the process. Given that she identified the problem on her own and decided to seek medical help and assistance, she will very likely be accepting the suggestions proposed.
There are a couple of outcomes that are likely to be realized. It would be prudent to ensure that the client has access to information and education concerning her health and weight (Austin Community College, n.d.). One outcome would be a change in diet and monitored exercise programs that will help her attain healthy weight. This would mean that she has a given eating program and a certain set of exercise with a weight goal at the end of the day. This would be manageable, realistic and measurable. However, it is a short term solution for the weight problem she may be facing. After she attains her ideal weight, it is very likely for her to relapse and the effort will go to waste.
A second outcome is that she will be advised and decide to individually change her lifestyle. This will be long term as she will monitor her food intake and exercise activity, and she can manage it on her own. This has a chance of being sustained in the long term because she is her own boss. Her determination will make her want to achieve her goal weight. She can also incorporate the things she prefers in her exercise program as opposed to when it is monitored. This method also ensures that she can make mistakes along the way and learn from them (Austin Community College, n.d.). This process will turn out more fruitful with minimal but regular consultation with the health practitioners. Also she will find that rapid weight loss is inappropriate and dangerous. She will have to do things gradually until her body can handle the pressure of exercise and measured portions.
Where the client prefers monitored assistance in weight loss, the nurse will teach and immediately monitor the progress. This means that the client cannot go wrong or injure themselves during the process. It will enable the nurse to advice and the patient to feed properly. The portions will be strictly observed and the results are likely to be quicker. The exercise will be monitored and assisted. The client will not injure themselves by trying to work out too hard and dangerously with the hope that they will lose weight faster. The nurses will teach and monitor to ensure safety and the achievement of the results. Finally, the patient will have to be psychologically prepared for the weight loss journey. This will involve counselling sessions. The nurse will know what the client wants, why they put on weight and why they now know they need to lose it. This makes it easier for the client to embark on a weight loss journey.
The client centered outcome requires little input from the nurses. The nurses in this outcome, however, are required to be more vigilant. They have to be flexible as the client is likely to make many mistakes. The diet has to be advised and with reason to avoid having the client starving themselves in order to lose weight appropriately. The client may be tempted to starve themselves in order to cut weight fast enough and this is dangerous and ineffective. The exercise is also very important but also risky if unmonitored. It is important to have the client understand what is safe and unsafe with reasons. It will also be important to consider the state of their health at the same time. Psychologically, the client has to know that stress does not help in weight loss. They need to make to understand that it is okay to ask for help where possible and avoid pitting all the burdens on themselves. Stress can contribute to weight gain while the client needs to cut the weight.
The client by having all her daily activities and being independent means that she is more prone to snacking alongside her activities. Her independence means that at the end of the day, she does not have time to exercise. The weight gain is uncontrollable with snacking and lack of exercise. It is also likely that she does not have to time to cook her meals and processed food is not safe for weight watching. The types of activities in her day may inhibit her movement. This means that the body accumulates the fats and the weight keeps on going up. The care offered by the medical practitioners is often offered to ensure that the process is safe. It also makes sure that the client starts from small changes giving the body time to adjust and gradually be in a position to handle a fully-fledged change in lifestyle. The amount of time the client can spare for exercising will take some time to adjust her schedule and make it normal with the exercise in place.
The modest life according to the client may entail indulging in high calorie diets from time to time which is dangerous for her health. The support systems may see nothing wrong with her weight. Given her height, her weight does not look that bad on her but it is dangerously high. It is also likely that she does not have motivators to help her cut weight or encourage her on the same. After working for most of her life, the client is likely to have taken the time after her retirement to relax and this does not help her weight loss journey. Achieving healthy weight for a woman of her age can boost her confidence and energy levels. Feeling young and energetic is important for an independent woman like the client. It is also important for the supports she has in her life to be fashioned in a way that they help her maintain healthy lifestyle activities. Exercising will ensure that she has less health problems as she grows older.
I would refer her to a nutritionist who can measure her body fat content. This would assist in planning her diet appropriately. This information is also good when setting her weight goals and the method of achieving it. I would also refer the client to a cardiologist to check her susceptibility to heart problems. This would help ensure that the exercises proposed are safe and healthy for her. The client should have a clean bill of health so that only the weight is being worked on as a preventive measure. I would also refer that she is taken through counselling to ensure that she will have made an informed decision. It is also important to encourage a patient during the program to achieve long lasting results.
The BMI result of the client sets the basis of the weight loss journey. The number on her scale needs to be brought down to ensure that she can avoid getting lifestyle diseases while they are preventable. It is also important for the client to understand that it is necessary for her to have taken the action is asking for a medical opinion on her health status with regards to her weight. The journey to a healthy BMI cannot be easy as it will cut out her favorite indulgences most especially the junk food in excess. Watching the food portions is not easy at the beginning but success is addictive. Once she has lost a few pounds she will be more receptive of the dietary program. She will also take part more freely in exercises. It will end up being part of her daily routine given that she is proud of her independence. Her health will be manageable with her determination. Setting small and achievable goals will lead her to the weight goal she has for herself. The client will have to reduce her weight to ensure that her BMI is at the safe 25.5kg/m2.
Austin Community College. (n.d.). Nursing Process: Planning Outcome Oriented Care. Retrieved from Austin Community College: http://www.austincc.edu/adnlev1/rnsg1413online/mod_nursing_process/outcome.html
Gans, K., Ross, E., Barner, C., Eaton, C., McMurray, J., & Wylie-Rosett, J. (2003). REAP and WAVE: New Tools to Rapidly Assess/Discuss Nutrition with Patients. Journal of Nutrition, 1,2.
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