The nurse is assessing the nutritional status of a patient who has cholelithiasis and a body mass index of 35. What action should the nurse take initially?
1. ask the patient to discuss typical daily menu choices
2. ask the patient to discuss strategies used to manage weight
3. ask if the patient takes daily supplemental vitamin C
4. ask if the patient has been skipping meals to reduce gallbladder pain
Correct Answer: 1
The nurse begins by assessing nutritional status, particularly diet history, height and weight, and skinfold measurements. Even though often obese, patients with gallbladder disease may have an imbalanced diet or specific vitamin deficiencies, particularly of the fat-soluble vitamins. Vitamin C is a water-soluble vitamin. Discussing strategies used to manage weight may be important in assessing causes of cholelithiasis pain, as fluctuating weight gains and losses can contribute to cholelithiasis, but this is the not the priority when assessing the patient's nutritional status. Asking if the patient has been skipping meals is important, but not as important as the diet history and typical food choices.
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