Close monitoring of bone mineral density should be a priority for the nurse practitioner following bariatric surgery because:
1. Clients are advised to avoid milk and milk products after surgery.
2. Vitamin D is only absorbed in the stomach, not in the lower jejunum.
3. Metabolic bone disease is more likely in clients who lose weight rapidly.
4. Low levels of vitamin B12 cause bones to lose density.
3
Rationale: Clients follow a low-fat diet after surgery but are allowed to eat smaller portions of all food groups. Nutrients, including vitamins and minerals, are absorbed in the intestines not the stomach. Metabolic bone disease is more likely to occur with rapid weight loss since stores prior to surgery are sequestered in adipose tissue and not readily available in the body. Vitamin B12 does not contribute to bone mineral density.
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